Identification of psychosocial distress: a comparison of internal medicine and family medicine residents.
OBJECTIVE
To compare the diagnostic accuracies of internal medicine and family medicine residents in identifying psychosocial distress in ambulatory patients.


METHODS
410 consecutive patients in two hospital-based residency clinics were enrolled. Psychosocial distress was assessed using the General Health Questionnaire (GHQ). Residents, blinded to the goals of the study and the results of the GHQ, documented clinically identified psychosocial distress.


RESULTS
Overall concordance between the residents and the GHQ in identifying the presence or absence of psychosocial distress was 60%. There was no difference in the diagnostic performances of the two resident groups. Sensitivity for the identification of psychosocial distress when the resident groups were combined was 32.3%.


CONCLUSIONS
The concordance between a commonly used, well-validated screening test for psychosocial distress and resident diagnosis was 60%. This may reflect the need for more effective training of residents in this area of diagnosis or the need for better screening methods.
Rosenberg
M
M
Internal Medicine Residency Program, Providence Medical Center, Portland, OR 97213.
Commerford
K
K
Driever
M
M
D000328:Adult; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires