title: A review of unrecognized mental illness in primary care. Prevalence, natural history, and efforts to change the course.
abstract: Studies of the prevalence, natural history, and outcome of unrecognized mental illness in general medical outpatient settings were reviewed. Approximately half of the patients with a psychiatric disorder were not recognized as having a mental illness by their primary care physician. The natural history of unrecognized mental illness suggests a poorer clinical course of anxiety disorders but not for depressive disorders. Most interventions demonstrated a significant improvement in the physician's ability to identify and treat psychiatric disorders but had a minimal effect on patient symptoms and no effect on short-term health care use. Although primary care physicians do not recognize psychiatric disorders in a high percentage of patients, efforts to improve recognition may not lead to decreased patient suffering or decreased health care costs.
authors.affiliation: Department of Family Medicine, Medical University of South Carolina, Charleston.
authors.forename: E S
authors.initials: ES
authors.lastname: Higgins
mesh_terms: D000328:Adult; D002648:Child; D018849:Controlled Clinical Trials as Topic; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011379:Prognosis; D014481:United States / Q000453:epidemiology