Screening for psychosocial distress: implications for prevention and health promotion

The importance of identifying the mental as well as physical health needs of individuals served in primary care settings has been documented in the United States, Great Britain, and developing countries. This study compared the prevalence of psychosocial distress across four demographically diverse ambulatory care clinics, and described the relationship among selected demographic characteristics (age, gender, marital status, race, education, and income) and psychosocial distress in order to develop a profile of high-risk clinics and patients. The sample was drawn from consecutive clinic attendees in two geographic regions of the United States. Psychosocial distress was measured with the Goldberg 28-item general health questionnaire (GHQ). As a group, 64% of the subjects had GHQ scores of less than 5, indicating they were not at risk; 26.5% were moderately distressed and 9.5% were highly distressed. The distressed tended to be chronically physically ill patients who attended two clinics. Multivariate nominal scale analysis (NMA) indicated that the sociodemographic variables accounted for 11% of the variance in GHQ scores. Younger (less than 60 yrs), white, low-socioeconomic subjects had a higher probability of falling into the high-risk category. Contrary to previous research findings, gender was not associated with distress.