Psychological problems in general practice patients: two assumptions explored.

Research is needed into the scientific basis for psychologists' 'specialist' model of service to general practitioners. This study evaluated two predictions of this service to general practitioners. This study evaluated two predictions of this model: firstly, that patients with psychological problems can be identified reliably; secondly, that they tax GPs' resources and ability disproportionately. To test these, psychologists observed 448 GP consultations. The GP and psychologist independently rated the involvement of psychological factors; the GP recorded his satisfaction with, and the psychologist the duration of, the consultation. Patients completed scales of psychiatric and social dysfunction. Both predictions were confirmed. Agreement between GPs' and psychologists' ratings of the presence of psychological factors was higher than reported previously, and not explained by the small correlation of psychiatric morbidity with each. Problems identified by GPs as psychological were associated with longer, repeated and less satisfying consultations.