[Diagnosis and Management of Patients with Psychogenic Disorders in Family Practice. Results of a Field Study]

The majority of patients with psychological disorders are seen in primary care. The diagnosis of the general practitioner (GP) influences decisively the subsequent treatment. Our study provides an insight into GP's diagnosis and treatment. 18 GP's and a psychotherapist rated 572 patients using a global diagnostic rating scale and the impairment score (BSS). The GPs noted down their treatment. The patients filled in symptom checklists (SCL-90-R, GHQ-12). Agreement between the doctor and the researchers on mental ill health was modest. GPs identified 51.4% of the patients with psychological disorders. Adjustment disorders were often ignored by GPs. They prescribed psychotherapy for 3.3% of their patients, especially patients with somatoform disorders and with high values in the impairment score. A path analysis shows, that psychotherapists' ratings agree much more with patients' self-assessment than GP ratings.