Psychological distress: outcome and consultation rates in one general practice

This paper reports a one-year follow-up of random samples of 90 male and 96 female patients attending one general practitioner. There was no statistically significant difference between men and women in the total score on the 28-item general health questionnaire or any of the subscores. However, the diagnostic labels applied to the two sexes were strikingly different as was the prescribing of psychotropic drugs. Outcome of psychological distress was assessed in terms of change in total general health questionnaire score. Two thirds of the patients (65%) showed normal scores at the beginning and end of the follow-up period, 19% changed from abnormal to normal and 8% changed from normal to abnormal. The remaining 9% had persistently high scores though less than half had been given a psychiatric diagnosis. They had very high consultation rates persisting over several years and three-quarters were known to have chronic physical illness. It seems possible that some patients with persistently high consultation rates who present with chronic, mainly somatic, symptoms may be or may become psychologically distressed to a significant degree and that this psychological distress goes unrecognized in the presence of physical disease.