[Why does the general practitioner overlooks psychological disorders in his patient?]

Physicians have a major screening function in the care of patients suffering from psychological disorders. Often, psychosocial disorders are overlooked in primary care. The study presented here investigates factors correlating with the identification of psychosocial disorders in primary care. Physician-patient consultations of 120 patients with psychological disorders of 16 primary care practices were analyzed with respect to doctor-patient interactions using Structured Analysis of Social Behavior (SASB). In addition, reported complaints, length of consultations and identification of psychological disorders by the physicians were analyzed. The physicians identified 60.8 % of the psychological disorders. There was a significant association between physician's identification of psychological disorders and (1) the severity of the disorder, (2) the number of complaints reported during consultation (3) the pattern of physician-patient interaction. A high frequency of interaction patterns referred to as complementary and controlling in terms of SASB categories, interferes with identification of psychological disorders. The study shows that the interactional process during primary care consultation is associated with physicians' identification of psychological disorders.