This Week In The Bmj

Asking patients about causes of symptoms may help improve detection of mental illness

BMJ 2001; 322 doi: (Published 13 January 2001) Cite this as: BMJ 2001;322:d

To study how patients' understanding of their symptoms influenced the detection of mental illness by primary care doctors, Araya et al studied 815 patients presenting at primary care clinics (p 79). The primary care physicians' assessment of whether the patient had a mental disorder was compared with a psychiatrist's assessment based on the clinical interview schedule. The psychiatrists thought 49% of patients had a mental disorder compared with the primary care doctors' 35%; 52% of cases identified by psychiatrists were undetected by the primary care doctor. Among the psychiatric cases 48% attributed their symptoms to psychological causes, and doctors were more likely to identify these patients as having a mental disorder. The authors say that asking patients directly about possible causes of their symptoms may improve diagnosis.