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Identification of psychosocial distress

A comparison of internal medicine and family medicine residents

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Abstract

Objective:To compare the diagnostic accuracies of internal medicine and family medicine residents in identifying psychosocial distress in ambulatory patients.

Design:410 consecutive patients in two hospital-based residency clinics were enrolled. Psychosocial distress was assessed using the General Health Questionnaire (GHQ). Residents, blinded to the goals of the study and the results of the GHQ, documented clinically identified psychosocial distress.

Main results:Overall concordance between the residents and the GHQ in identifying the presence or absence of psychosocial distress was 60%. There was no difference in the diagnostic performances of the two resident groups. Sensitivity for the identification of psychosocial distress when the resident groups were combined was 32.3%.

Conclusions:The concordance between a commonly used, well-validated screening test for psychosocial distress and resident diagnosis was 60%. This may reflect the need for more effective training of residents in this area of diagnosis or the need for better screening methods.

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Authors and Affiliations

  1. the Internal Medicine Residency Program, Providence Medical Center, Portland, Oregon

    Mark Rosenberg MD

  2. the Nursing Administration/QA & Research, Providence Medical Center, Portland, Oregon

    Marie Driever PhD, RN

  3. the Department of Family Practice, Oregon Health Sciences University, Portland, Oregon

    Kate Commerford PhD

Authors
  1. Mark Rosenberg MD
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  2. Kate Commerford PhD
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  3. Marie Driever PhD, RN
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Rosenberg, M., Commerford, K. & Driever, M. Identification of psychosocial distress. J Gen Intern Med 6, 529–534 (1991). https://doi.org/10.1007/BF02598222

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