Mental illness in a general hospital's family medicine clinic in Taiwan.

Abstract

There has been a paucity of evidence-based information regarding mental illness in general medical settings among the Chinese population. Aims of the present study are to investigate the patterns and distribution of mental disorders among family medicine clinic attenders, illness behavior of attenders with such disorders, and the recognition and management given by family physicians for them. A random sample (n = 200) of patients attending a family medicine clinic in a medical center in Taiwan, received a standardized psychiatric assessment using the semistructured Clinical Interview Schedule (CIS) after they had seen the family physician. A total of 12 family physicians, who were blind to the psychiatric status of their patients, were then asked to assess the physical and psychological condition of the subjects. Of all study subjects, 51% had at least one psychiatric diagnosis based on the CIS assessment, and the corresponding figure was 21.5% from family physicians. While the specificity of psychiatric case identification among family physician was high (91%), the sensitivity was very low (30%), especially for depressive disorders and alcohol-related disorders. Because the same magnitude of psychiatric morbidity and similarly low detection rates by general medical physicians were found in other developing countries, the improvement in psychiatric education for medical students and family physicians is highly implicated there.