N Z Med J. 2001 Jan 26;114(1124):13-6.
To carry out a pilot study in two regions in order to investigate prevalence of psychological problems in primary care in New Zealand.
General Practitioners (GPs) within two geographic regions were randomly selected. All adult attenders at their practice on selected days were administered a short questionnaire, the GHQ-12, which assesses the presence of psychological symptoms. The GP recorded the reasons for each consultation, and was interviewed at the end of each day about selected patients, to determine their opinion about the type of psychological problems experienced.
Three-quarters of selected GPs (76%) agreed to participate. 96% of patients attending their GP agreed to complete the GHQ. Scores from 385 completed GHQ screening questionnaires suggested that 23.4% of GP patients had significant psychological symptoms. When GPs were asked about the main reason for consultation, they identified only 5.7% of current consultations as being for psychological reasons. In contrast, the GPs thought that 20.6% of patients described having some symptoms which were either mildly, moderately or completely psychological in the current consultation, and recognised that 17.4% of their patients had a mild, moderate or severe case of psychological disorder over the past twelve months.
GPs identified one in five of their patients as having symptoms which were mildly, moderately or completely psychological, although psychological factors were the main reason for consultation in only one patient in twenty. Previous reports of very low rates of psychological problems among GP attenders in New Zealand have been thought to indicate major differences in access to health care or prevalence of common mental disorders within primary care services in this country. However, the apparently low rates of conspicuous mental disorder in New Zealand general practices may be better explained as an artifact of the type of questions asked.
在两个地区开展一项试点研究，以调查新西兰初级保健中心理问题的患病率。
随机选取两个地理区域内的全科医生（GPs）。在选定的日子里，所有到他们诊所就诊的成年人都要填写一份简短的问卷，即一般健康问卷-12（GHQ-12），该问卷用于评估心理症状的存在情况。全科医生记录每次咨询的原因，并在每天结束时就选定的患者接受访谈，以确定他们对所经历的心理问题类型的看法。
四分之三选定的全科医生（76%）同意参与。96%到全科医生处就诊的患者同意完成GHQ问卷。385份完成的GHQ筛查问卷的得分表明，23.4%的全科医生的患者有明显的心理症状。当被问及咨询的主要原因时，全科医生仅将当前咨询的5.7%确定为出于心理原因。相比之下，全科医生认为20.6%的患者在当前咨询中描述有一些症状，这些症状要么轻微、中度，要么完全是心理方面的，并且认识到17.4%的患者在过去十二个月中有轻度、中度或重度心理障碍。
全科医生确定五分之一的患者有轻微、中度或完全是心理方面的症状，尽管心理因素仅在二十分之一的患者中是咨询的主要原因。此前关于新西兰全科医生就诊者中心理问题发生率极低的报告被认为表明该国初级保健服务中在获得医疗保健的机会或常见精神障碍的患病率方面存在重大差异。然而，新西兰全科医疗中明显较低的明显精神障碍发生率可能更好地解释为所提问题类型的一种人为现象。
