Skip to main content Accessibility help
×
Home

The ability of trainee general practitioners to identify psychological distress among their patients

  • D. P. Goldberg (a1), L. Jenkins (a1), T. Millar (a1) and E. B. Faragher (a1)

Synopsis

It is argued that a general practitioner's ability to make accurate ratings of psychological distress is partly determined by the rate at which patients emit cues that are indicative of such distress. This study addresses the behaviours of doctors which influence the rates at which patients emit such cues. Consultations were videotaped involving six General Practice Vocational Trainees, three of them poor, and three of them able identifiers of emotional illness. Consultations were selected so that each trainee was rated interviewing 4 patients with low GHQ scores, and 4 patients with high scores. Behaviours are described which lead to increased cue emission and which are also practised more frequently by able identifiers, while other behaviours reduce cue emission and are practised less frequently by them. Another set of behaviours is no more frequent among the able identifiers, but when practised by able identifiers is associated with increased cue emission by the patients, and when practised by poor identifiers with unaltered or decreased cue emission. Interviews that are ‘patient-led’ are associated with increased rates of cue emission, while those that are ‘doctor-led’ are associated with lower rates. The implications of these findings for training doctors working in general medical settings are discussed.

Copyright

Corresponding author

1Address for correspondence: Professor D. P. Goldberg, University of Manchester, School of Psychiatry and Behavioural Science, Withington Hospital, West Didsbury, Manchester M20 8LR.

References

Hide All
Aitkin, M., Anderson, D., Francis, B. & Hinde, J. (1989). Statistical Modelling in GLIM (5). Oxford Science Publications: London.
Baker, R. (1985). GLIM 3.77 Reference Manual. Numerical Algorithms Group: Oxford.
Breslow, N. E. (1984). Extra-Poisson variation in log-linear models. Journal of the Royal Statistical Society 33, 3844.
Byrne, P. S. & Long, B. E. (1976). Doctors Talking to Patients. Her Majesty's Stationery Office: London.
Davenport, S., Goldberg, D. & Millar, T. (1987). How psychiatric disorders are missed during medical consultations. Lancet ii, 439441.
Gask, L., McGrath, G., Goldberg, D. & Millar, T. (1987). Improving the psychiatric skills of established general practitioners: evaluation of group teaching. Medical Education 21, 362369.
Gask, L., Goldberg, D., Lesser, A. & Millar, T. (1988). Improving the psychiatric skills of the general practice trainee: an evaluation of a group training course. Medical Education 22, 132138.
Goldberg, D. P. & Bridges, K. (1987). Screening for psychiatric illness in general practice: the general practitioner versus the screening questionnaire. Journal of the Royal College of General Practitioners 37, 1518.
Goldberg, D. P. & Huxley, P. J. (1980). Mental Illness in the Community – the Pathway to Psychiatric Care. Tavistock Publications: London.
Goldberg, D. P. & Huxley, P. J. (1992). Common Mental Disorders – A Biosocial Model. Routledge: London.
Goldberg, D. P. & Williams, P. (1988). A Users Guide to the General Health Questionnaire. NFER-Nelson: Windsor.
Goldberg, D. P., Steele, J., Johnson, A. & Smith, C. (1982). Ability of primary care physicians to make accurate ratings of psychological disturbance. Archives of General Psychiatry 39, 829833.
Goldberg, D. P., Gask, L. & O'Dowd, T. (1989). The treatment of somatisation: teaching techniques of re-attribution. Journal of Psychosomatic Research 33, 689695.
Hennrikus, D. (1986). An observational study of the detection of psychological disturbance by general practitioners. Ph.D. thesis, University of Newcastle, New South Wales.
Jenkins, R., Smeeton, N. & Shepherd, M. (1988). Classification of Mental Disorder in Primary Care. Psychological Medicine Monograph Supplement No. 12. Cambridge University Press: Cambridge.
Levenstein, J. H.. McCracken, E., McWhinney, I. R., Stewart, M. A. & Brown, J. B. (1986). The patient-centred clinical method. Family Practice 3, 2430.
Marks, J., Goldberg, D. & Hillier, V. (1979). Determinants of the ability of general practitioners to detect psychiatric illness. Psychological Medicine 9, 337353.
Millar, T. & Goldberg, D. P. (1991). Determinants of the ability of general practitioners to manage common mental disorders. British Journal of General Practice 41, 357359.
Pendleton, D. (1983). Doctor-patient communication: a review. In Doctor Patient Communication (ed. Pendleton, D. and Hasler, J.), pp. 556. Academic Press: London.
Raynes, N. V. (1979). Factors affecting the prescribing of psychotropic drugs in general practice consultations. Psychological Medicine 9, 671679.
Tuckett, D., Boulton, M., Olson, C. & Williams, A. (1985). Meeting Between Experts: an Approach to Sharing Ideas in Medical Consultations.Tavistock:London.
Tylee, P. & Freeling, P. (1989). The recognition, diagnosis and acknowledgement of depressive disorders by general practitioners. In Depression: an Integrative Approach (ed. Paykel, E. and Herbst, K.), pp. 216231. Heinemann: London.

The ability of trainee general practitioners to identify psychological distress among their patients

  • D. P. Goldberg (a1), L. Jenkins (a1), T. Millar (a1) and E. B. Faragher (a1)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed