Munk-Jørgensen P
Psychol Med. 1986 Aug;16(3):611-9. doi: 10.1017/s0033291700010369.
In a Danish community psychiatric service the patients referred from general practitioners (GPs) to the community psychiatric service (CPS) are compared with matched individuals with conspicuous psychiatric morbidity treated in general practice only. The psychopathology of the referred patients is more severe, as estimated by two different methods. They make fewer social contacts and their work situations are unfavourable. It was found that to a great extent the GPs refer their patients with mental disorders to the CPS so that the 'filter' between the GP and the CPS is very permeable. Of the patients treated by the GPs only (the matched group), no more than 54% were assessed by a psychiatrist as psychiatric 'cases'. Psychopathology thus only partly determines the GPs' assessment of psychiatric 'caseness', in which social impairment plays an important part. The GPs diagnose more mental disorder than the psychiatrists, possibly because of an intimate acquaintance with the anamnesis.
在丹麦社区精神科服务中，将从全科医生（GP）转介至社区精神科服务（CPS）的患者与仅在全科医疗中接受治疗的、有明显精神疾病的匹配个体进行比较。通过两种不同方法评估发现，转介患者的精神病理学症状更为严重。他们的社交接触较少，工作状况不佳。研究发现，全科医生在很大程度上会将患有精神障碍的患者转介至社区精神科服务，因此全科医生与社区精神科服务之间的“过滤器”非常容易穿透。在仅由全科医生治疗的患者（匹配组）中，不超过54%被精神科医生评估为精神科“病例”。因此，精神病理学仅部分决定了全科医生对精神科“病例”的评估，其中社会功能损害起着重要作用。全科医生诊断出的精神障碍比精神科医生更多，这可能是因为他们对病史有深入了解。
