Identification of common mental disorders by general medical doctors in Taiwan

The aims of the study were to examine the detection rate of common mental disorders (CMD) by general medical doctors and which patient-related factors associated with increased chances of detection in Taiwan. A two-phase case-identification using the Chinese Health Questionnaire and the Revised Clinical Interview Schedule (CIS-R) was carried out among a sample of consecutive new attenders (n=990) in community and hospital-based clinics. Physicians completed a checklist of the problems that they identified during each consultation. General medical doctors missed more than 85% of the CIS-R cases of defined mental disorder. Physicians performed better identification of CMD among attenders with a higher socioeconomic status, without physical illness, having psychological presentation or attribution, suffering from more serious common mental disorders, or having a longer duration of illness. The very low identification rate of CMD has strongly implied the need to improve postgraduate training in psychiatry for general medical doctors in Taiwan. Simply adding one or two questions about mood and attributions of presenting symptoms might help physicians to identify CMD.