Detection and diagnosis of psychiatric disorders in primary medical care settings

Jeffrey P Staab, Catherine J. Datto, Robert M. Weinrieb, Peter Gariti, Moira Rynn, Dwight L. Evans

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Research efforts accelerated in the 1990s to define the presentation of common psychiatric disorders in primary care settings. Two diagnostic instruments, the DSM-IV-PC and the PRIME-MD, were introduced in 1994, and a self-report form of the PRIME-MD, the PHQ, was published in 1999. These tools have streamlined the larger, often cumbersome psychiatric nomenclature of the DSM-III and DSM-IV and appear to be more useful in general medical settings. It still is not practical to use either instrument in its entirety for all patients in a busy primary care practice. Studies have suggested an efficient and effective, two-step method of screening primary care patients for psychiatric disorders, however. In this approach, a limited number of probing questions extracted from the PRIME-MD or PHQ (or DSM-IV-PC) are posed to patients, either in person or by a written self-report (i.e., a general health update or review of systems). Then a follow-up evaluation is done to confirm or refute positive screening results. Short, simple questionnaires that address specific topics (e.g., CAGE for alcohol screening or the GDS for mood disorders in older adults) complete and complement this approach. This method has the advantage of being easy to incorporate into routine office practice using minimal physician or office staff time, while showing acceptable sensitivity and specificity in studies to date. More research, particularly prospective studies, is needed to confirm the effectiveness of this approach and expand it beyond the few available studies that have focused mostly on depressive disorders.

Original languageEnglish (US)
Pages (from-to)579-596
Number of pages18
JournalMedical Clinics of North America
Volume85
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

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Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Primary Health Care
Psychiatry
Self Report
Physicians' Offices
Depressive Disorder
Mood Disorders
Research
Terminology
Alcohols
Prospective Studies
Sensitivity and Specificity
Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Detection and diagnosis of psychiatric disorders in primary medical care settings. / Staab, Jeffrey P; Datto, Catherine J.; Weinrieb, Robert M.; Gariti, Peter; Rynn, Moira; Evans, Dwight L.

In: Medical Clinics of North America, Vol. 85, No. 3, 2001, p. 579-596.

Research output: Contribution to journalArticle

Staab, Jeffrey P ; Datto, Catherine J. ; Weinrieb, Robert M. ; Gariti, Peter ; Rynn, Moira ; Evans, Dwight L. / Detection and diagnosis of psychiatric disorders in primary medical care settings. In: Medical Clinics of North America. 2001 ; Vol. 85, No. 3. pp. 579-596.
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