Screening for mental illness in primary care clinics.
OBJECTIVE
To assess the prevalence of mental disorders in inner city outpatient clinics and to improve the diagnosis of mental illness in primary care.


METHODS
The Problem Oriented Patient Report (POPR), a patient self-report checklist, was administered to 362 outpatients at two inner-city Buffalo primary care clinics. Patients' completed POPR checklists were evaluated to identify those with potential mental illness diagnoses and were available for the physicians' review during the patients' visits. After the visit, clinical charts were reviewed to determine the frequency of new mental illness diagnoses among continuing and new patients.


RESULTS
The screening checklist (POPR) revealed potential mental illnesses in 148/362 outpatients, of which 98% had not been identified by the physicians who had reviewed the patients' completed POPR forms. Only five new diagnoses of mental illnesses were independently made by clinics' physicians-all in follow-up (continuing) patients.


CONCLUSIONS
The physicians in the two clinics did not diagnose mental illnesses in their patients, even when written checklists of self-reports were available to them. Differences in staff attitudes may influence the data collection process, and patients' as well as physicians' responses. A weakness of this study is that the POPR might generate false positive results. Even if this were the case, the rate of previous diagnoses was still extremely low.
Kahn
Linda S
LS
Department of Psychiatry, State University of New York at Buffalo School of Medicine, USA.
Halbreich
Uriel
U
Bloom
Michael S
MS
Bidani
Rakesh
R
Rich
Ellen
E
Hershey
Charles O
CO
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires