Improving recognition of psychiatric disorders in a primary care practice.

Primary care physicians can increase their recognition of psychiatric disorders in several ways. The first and most important is to maintain a high index of suspicion for these disorders, which are prevalent in primary care patients, and to know the frequent symptom presentations, both overt and covert, of the most common disorders. A variety of psychiatric screening questionnaires can be useful and may be given routinely or when a psychiatric disorder is suspected. Alternatively, psychiatric screening questions can be incorporated into the usual patient interview. Establishment of a good working relationship with a psychiatrist knowledgeable in current psychiatric diagnosis and therapy, including psychopharmacology, is advisable. Psychiatric consultation may be sought when diagnostic questions arise, and referral to a psychiatrist or coordinated treatment is often useful for patients with severe or persistent symptoms.