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The FIP study: a randomised, controlled trial of screening and recognition of psychiatric disorders
Kaj Sparle Christensen1, Tomas Toft, Lisbeth Frostholm
1Research Unit for Functional Disorders, Aarhus University Hospital, Research Unit for General Practice, Aarhus University. kspar@akh.aaa.dk
Background:
Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting results.
Aim:
To examine the effect of a routinely administered questionnaire on recognition of common psychiatric disorders in general practice.
Design Of Study:
Randomised controlled trial.
Setting:
Twenty-eight general practices in Aarhus County, Denmark.
Method:
Thirty-eight general practitioners (GPs) and 1785 consecutive patients, aged 18-65 years old, presenting with a new health problem, participated. Before consultation, patients were screened using a brief screening questionnaire (SQ) including somatisation, anxiety, depression, and alcohol abuse scales. Patients were randomised to one of two groups: 900 questionnaires were disclosed and scored by the GPs, 885 were blinded. A stratified subsample of 701 patients was interviewed after the consultation using a standardised psychiatric research interview (SCAN).
Results:
Overall the GPs' recognition rates were 14% (95% confidence interval [CI] = -2 to 30) better for depression and 35% (95% CI = 2 to 68) better for alcohol problems when SQs were disclosed. Recognition rates for anxiety improved 8% (95% CI = -9 to 26) overall. In the case of somatoform disorders, disclosure showed no effect overall. Among those with high SQ scores, however, disclosure increased recognition rates on any mental disorder evaluated.
Conclusion:
This study demonstrated limited usefulness for routine screening for common psychiatric disorders. However, findings suggest that the SQ may be useful for case-finding among a subgroup of patients with high SQ scores.
