Capacidad de detección de patología psiquiátrica por el médico de familia

OBJECTIVE: To determine the ability of family physicians to detect psychiatric disorders, comparing the presence of psychiatric disorders detected using validated tests and referrals by family physicians. DESIGN: Cross-sectional, two-phase study. LOCATION: Primary healthcare centres in an urban area of Madrid. PARTICIPANTS: Patients between 18 and 65 years attending primary healthcare centres for non-administrative purposes. MAIN MEASUREMENTS: To detect psychiatric disorders in the waiting room, an interview was performed using GHQ-28 and MULTICAGE CAD-4 in the screening phase (considered positive: score of 6 or higher on the GHQ-28 or a score 2 or higher on MULTICAGE CAD-4). Patients with a positive score and 20% with negative were recruited for the second phase (case identification) using MINI interview. During family physician consultation, the patient gave his doctor a card with an identification number to record the presence of psychiatric illness in his/her opinion and whether there was treatment with psychotropic drugs. RESULTS: A total of 628 subjects participated. The prevalence of psychiatric disorders corrected by two phase methodology was 31.7% (95% CI: 27.9 to 35.5). Of the 185 patients with a psychiatric disorder detected, 44.2% (95% CI: 36.7 to 51.7) were identified as patients with psychiatric disorders by their family physician. Disorders best detected were: hypomania, dysthymic disorder, depressive episode with melancholic symptoms, and panic disorder. CONCLUSIONS: A significant percentage of patients with possible psychiatric disorders detected with validated test have not been identified by their family physician.