Chocrón Bentata L, Vilalta Franch J, Legazpi Rodríguez I, Auquer K, Franch L, Ramírez Arrizabalaga R
Centro de Salud Maluquer Salvador, Girona.
Aten Primaria. 1996 Jun 15;18(1):22-6.
To determine the percentage of psychiatric disorders recognised by primary care doctors and what influence the reason for consultation exerts on the psychiatric diagnosis.
A crossover study of the prevalence of psychopathology. A two-phase study was performed, with systematic sampling of one in every four visits. The GHQ-28 was used in the first phase and Goldberg's CIS in the second; a diagnosis was assigned in line with the criteria of the DSM-III-R. This diagnosis was compared with the general practitioner's, if this existed.
"Maluquer Salvador" Health Centre in Girona.
A sample of 400 patients between 15 and 65 who attended the centre. 2.9% were lost (2.1% in the first phase and 0.8% in the second).
The GP diagnosed 36.7% of the psychiatric disorders of those attending his/her clinics, mainly because only half the patients "suggested" their problem. In 21.2% of the cases when patients "suggested" their psychopathology, they left the consultation without a diagnosis. This was particularly serious in the case of major depression.
Given the high prevalence of psychopathology, the low diagnostic percentages of the general practitioner's and the difficulty the patient has in suggesting his/her problem, primary care clinics clearly require improvement in case-finding and the use of the GHQ-28 as an instrument in case-finding.
确定初级保健医生识别出的精神疾病比例，以及就诊原因对精神疾病诊断有何影响。
一项关于精神病理学患病率的交叉研究。研究分两个阶段进行，每四次就诊中系统抽取一次。第一阶段使用一般健康问卷-28（GHQ-28），第二阶段使用戈德堡综合精神病量表（CIS）；根据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）的标准进行诊断。若有全科医生的诊断，则将此诊断与之进行比较。
赫罗纳的“马卢克·萨尔瓦多”健康中心。
该中心400名年龄在15至65岁之间的患者样本。2.9%的患者失访（第一阶段为2.1%，第二阶段为0.8%）。
全科医生诊断出其诊所就诊患者中36.7%的精神疾病，主要原因是只有一半的患者“提及”了自己的问题。在21.2%的患者“提及”其精神病理学问题的病例中，他们未得到诊断就离开了诊室。这在重度抑郁症病例中尤为严重。
鉴于精神病理学的高患病率、全科医生的低诊断率以及患者在提及自身问题时存在困难，初级保健诊所显然需要改进病例发现工作，并将GHQ-28用作病例发现工具。
