EDITOR—Kessler et al found that doctors detected psychiatric illness in less than half of patients scoring highly on the general health questionnaire (85% of patients with a normalising attributional style and 38% with a psychologising style were not detected).1 These data are in accordance with the work that we did in four Spanish primary care centres. Using the general health questionnaire-28 in the first part of the study and a SCAN interview 2 3 in the second, we found similar figures of non-recognition of psychiatric illness4 and the same relevance of somatisation to lower rates of recognition of mental illness by general practitioners.5

In her commentary on the paper Heath doubts that scoring highly on the general health questionnaire could be equated with having a treatable disorder. We agree with her that the general health questionnaire is a screening questionnaire, not a diagnostic tool, and that doctors should not talk of depression and anxiety just because patients scored highly on the questionnaire. …