[The recognition of mental disease in primary health care and its determining factors]

Abstract

Aims: It is known that recognition of mental illness by the General Practitioner (GP) is low. The GP usually identify less than a half of these cases. Our aim has been to study the prevalence of mental disorders in Primary Care, and to analyse the influence of several variables over the identification of mental illness by the GP.

Methods: Transversal study in four Primary Care centres in the north of Spain. We studied 823 patients attended with a <<new illness>> in primary care practices. Patients were evaluated with the GHQ-28, Belloc questionnaire, and data regarding diagnosis and treatment provided by the GP, in addition of additional information from medical records.

Results: The prevalence of mental illness according the GHQ-28 was 33%, being higher in women (38%) than in men (24%). Mental illness diagnosed by the GP was the 14,1% of cases. The rate of patients with mental disorders (diagnosed by the GHQ) recognised by the GP was the 29%. In a logistic regression, relevant factors affecting recognition were i) presentation with physical symptoms, ii) clinical severity (measured by GHQ), and, iii) employment (only for older patients).

Conclusions: <<Patient barriers>> can explain the low rate of identification of mental illness by the GP.