Psychiatric illness detection: A comparison of osteopaths and M.D.s in private family practice

Abstract

The detection of psychiatric illness is increasingly becoming the responsibility of non-psychiatric physicians. As part of a large scale epidemiological survey of psychiatric illness in a metropolitan area, primary care M.D.s and osteopaths were compared for their ability to detect psychiatric illness. Although neither group of physicians detected as much illness as patient self-assessments revealed, osteopaths detected significantly more psychiatric illness than M.D.s. When, however, physician and patient reports of illness were juxtaposed, to determine concordance, M.D.s and osteopaths showed similar degrees of overall accuracy. Osteopaths tended to detect more true positives, while M.D.s detected more true negatives. Different practice and social characteristics were not found to account for practice differences in physician rates of psychiatric illness detection. Osteopaths appeared to be performing at least as effectively as M.D.s in a first line of defence against mental illness.