Skip to main content
SpringerLink
Log in

Primary Care and Clinical Psychology: Assessment Strategies in Medical Settings

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

There is ample evidence regarding medical-psychological comorbidity to consider clinical psychology as a viable component of health care services in medical settings. Psychologists can become valuable assets to primary care physicians who treat a high number of primary psychiatric cases as well as medical cases with secondary psychological symptoms. Psychologists who function in hospital-based clinics as well as affiliates with primary care (PC) offices can provide empirically supported assessment services that can make treatment more effective and efficient. Multiple studies indicate high prevalence rates of psychiatric patients in PC settings using various instruments. This paper reviews selected assessment tools that have established diagnostic validity and reliability that can be both strategic for patient care and useful to reinforce psychologist collaboration with primary care physicians (PCP).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Angst, J., Merikangas, K. R., & Preisig, M. (1997). Subthreshold syndromes of depression and anxiety in the community. Journal of Clinical Psychiatry, 58(8), 6–10.

    Google Scholar 

  • Arthur, A., Jagger, C., Lindesay, J., Graham, C., & Clarke, M. (1999). Using an annual over–75 health check to screen for depression: Validation of the short Geriatric Depression Scale (GDS15) within general practice. International Journal of Geriatric Psychiatry, 14(6), 431–439.

    Google Scholar 

  • Barlow, D.H. (1988). Anxiety and its disorders. NewYork: Guilford.

    Google Scholar 

  • Beck, A. T., & Steer, R. A. (1993). BAI, Beck Anxiety Inventory manual. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI II: Beck Depression Inventory—second edition manual. San Antonio: The Psychological Corporation.

    Google Scholar 

  • Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive therapy of substance abuse. New York: Guilford.

    Google Scholar 

  • Berman, W. H., Rosen, C. S., Hurt, S. W., & Kolarz, C. M. (1998). Toto, we're not in Kansas anymore, measuring and using outcomes in behavioral health care. Clinical Psychology, Science and Practice, 5(1), 115–133.

    Google Scholar 

  • Brackley, M. H. (1997). Mental health assessment/mental status examination. Nurse Practitioner Forum, 8(3), 105–113.

    Google Scholar 

  • Brown, C., Schulberg, H. C., & Madonia, M. J. (1995). Assessment of depression in primary care practice with the Beck Depression Inventory and the Hamilton Rating Scale for Depression. Psychological Assessment, 7(1), 59–65.

    Google Scholar 

  • Campbell, T. L., & McDaniel, S. H. (2000). Evaluating the effectiveness of on–site mental health in primary care: A review from Great Britain. Families, Systems and Health, 18(3), 277–278.

    Google Scholar 

  • Carmin, C. N., & Klocek, J. W. (1998). To screen or not to screen: Symptoms identifying primary care medical patients in need of screening for depression. International Journal of Psychiatry in Medicine, 28(3), 293–302.

    Google Scholar 

  • Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits–Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D. A., Johnson, S. B., McCurry, S., Mueser, K. T., Pope, K. S., Sanderson, W. C., Shoham, V., Stickle, T., Williams, D. A., & Woody, S. R. (1998). Update on empirically validated therapies II. The Clinical Psychologist, 51(1), 3–16.

    Google Scholar 

  • Clark, D. A., & Beck, A. T. (1999). Scientific Foundations of Cognitive Theory and Therapy of Depression. Wiley, New York.

    Google Scholar 

  • Conner, K. M., Davidson, J. R. T., & Churchill, L. E. (1998). Psychometric properties of the social phobia inventory (SPIN): A new self–rating scale. Unpublished manuscript.

  • DePaulo, J. R. (1996). Depression. In J. D. Stobo, D. B. Hellmen, P. W. Ladenson, B. G. Petty, & T. T. Traill (Eds.), The principles and practice of medicine (23rd ed. pp. 922–926). Connecticut: Appleton & Lange.

    Google Scholar 

  • Derogatis, L. R. (1983). SCL–90–R administration, scoring & procedures manual II. Towson, MD: Clinical Psychometric Research.

    Google Scholar 

  • Derogatis, L. R. (1993). BSI Brief Symptom Inventory administration, scoring, and procedures manual. Minneapolis, MN: National Computer Systems.

    Google Scholar 

  • DiScipio, W. J., & Weigand, P. A. (1989). Psychological assessment in medically ill populations. In S. W. Wetzler & M. M. Katz (Eds.), Contemporary approaches to psychological assessment (pp. 310–324). New York: Brunner Mazel.

    Google Scholar 

  • Dobson, K. S., & Shaw, B. F. (1986). Cognitive assessment with major depressive disorders. Cognitive Therapy and Research, 10(1), 13–29.

    Google Scholar 

  • Eisen, S. V., & Youngman, D. (1994). Instruction manual for BASIS–32. Belmont, MA: Department of Mental Health Services Research, McLean Hospital.

    Google Scholar 

  • Engel, C. C., Kronke, K., & Katon, W. J. (1994). Mental health services in army primary care: The need for a collaborative health care agenda. Military Medicine, 159(3), 203–209.

    Google Scholar 

  • Fifer, S. K., Mathias, S. D., Patrick, D. L., Mazonson, P. D., Lubeck, D. P., & Buesching, D. P. (1994). Untreated anxiety among adult primary care patients in a health maintenance organization. Archives of General Psychiatry, 51(9), 740–750.

    Google Scholar 

  • Frances, R. J., & Miller, S. I. (1991). Addiction treatment: The widening scope. In R. J. Frances, & S. I. Miller (Eds.), Clinical textbook of addictive disorders. New York: Guilford.

    Google Scholar 

  • Gavin, D. R., Ross, H. E., & Skinner, H. A. (1989). Diagnostic validity of the drug abuse screening test in the assessment of DSM III drug disorders. British Journal of Addiction, 84, 301–307.

    Google Scholar 

  • Giles, T. R. (1993). Managed mental health care: A guide for practitioners, employers, and hospital administrators. Boston: Allyn and Bacon.

    Google Scholar 

  • Goodman, W. K., Price, L. H., & Rasmussen, S. A. (1989). The yale–brown obsessive compulsive scale I: Development, use and reliability. Archives of General Psychiatry, 46, 1006–1011.

    Google Scholar 

  • Gotlib, I. H., & Cane D. B. (1989). Self–report assessment of depression and anxiety. In P. C. Kendall, & D. Watson (Eds.), Anxiety and depression, distinctive and overlapping features (pp. 131–170). San Diego: Academic Press.

    Google Scholar 

  • Haley, W. E., Mcdaniel, S. H., Bray, J. H., Frank, R. G., Heldring, M., Bennett Johnson, S., Go Lu, E., Reed, G. M., & Wiggins, J. G. (1998). Psychological practice in primary care settings: Practical tips for clinicians. Professional Psychology, Research and Practice, 29(3), 237–244.

    Google Scholar 

  • Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 56–62.

    Google Scholar 

  • Hirschfeld, R. M. A., Keller,M. B., Panico, S., Arons, B. S., Barlow, D., Davidoff, F., Endicott, J., Froom, J., Goldstein, M., Gorman, J. M., Guthrie, D., Marek, R.G., Maurer, T., Meyer, R., Phillips, K., Ross, J., Schwenk, T. L., Sharfstein, S. S., Thase, M. E., & Wyatt, R. J. (1997). The national depressive and manicdepressive association consensus statement on the undertreatment of depression. JAMA, 277(4), 333–340.

    Google Scholar 

  • Hoffman, F. L., Capelli, K., & Mastrianni, X. (1997). Measuring treatment outcome for adults and adolescents: Reliability and validity of BASIS–32. Journal of Mental Health Administration, 24(3), 316–331.

    Google Scholar 

  • Hollon, S. D., Kendall, P. C., & Lumry, A. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95(1), 52–59.

    Google Scholar 

  • Ingram, R. E., Miranda, J., & Segal, Z. V. (1998). Cognitive vulnerability to depression. New York: Guilford.

    Google Scholar 

  • Katerndahl, D. A., & Trammell, C. (1997). Prevalence and recognition of panic states in STARNET patients presenting with chest pain. Journal of Family Practice, 45(1), 54–63.

    Google Scholar 

  • Kendler, K. S., Heath, A. C., Martin, N. G., & Eaves, L. J. (1987). Symptoms of anxiety and symptoms of depression: Same genes, different environments? Archives of General Psychiatry, 44(May), 451–457.

    Google Scholar 

  • Levenson, J. L., Hamer, R. M.,& Rossiter, L. F. (1990). Relation of psychopathology in general medical inpatients to use and cost of services. American Journal of Psychiatry, 147(11).

  • Lewis, G., Sharp, D., Bartholomew, J., & Pelosi, A. J. (1996). Computerized assessment of common mental disorders in primary care: Effect on clinical outcome. Family Practice, 13(2), 120–126.

    Google Scholar 

  • Morrow, L. A., & Beers, S. R. (1995). Neuropsychological assessment: When to ask for it, what to expect? Journal of Psychological Practice, 1 (4), 182–190.

    Google Scholar 

  • O'Donnell, W. E., DeSoto, C. B., DeSoto, J. L., & Reynolds, D. M. (1994). The Neuropsychological Impairment Scale (NIS) manual. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Pace, T. M., Chaney, J. M., Mullins, L. L., & Olson, R. A.(1995). Psychological consultation with primary care physicians: Obstacles and opportunities in the medical setting. Professional Psychology: Research and Practice, 26 (2), 123–131.

    Google Scholar 

  • Robinson, J. W., & Roter, D. L. (1999). Psychosocial problem disclosure by primary care patients. Social Science and Medcine, 48 (10), 1353–1362.

    Google Scholar 

  • Romanoski, A. J. (1996). Alcohol and drug dependence. In The principles and practice of medicine (23rd ed.). Connecticut: Appleton and Lange.

    Google Scholar 

  • Roy–Byrne, P., Russo, J., Rabin, L., Fuller, K., Jaffe, C., Ries, R., Dagadakis, C., & Avery, D. (1998). A brief medical necessity scale for mental disorders: Reliability, validity and clinical utility. The Journal of Behavioral Health Services and Research, 25 (4), 412–424.

    Google Scholar 

  • Sherbourne, C. D., Jackson, C. A., Meredith, I. S., Camp, P., & Wells K. B. (1996). Prevalence of comorbid anxiety disorders in primary care outpatients. Archives of Family Medicine, 5 (1), 27–34.

    Google Scholar 

  • Sherbourne, C. D., Wells, K. B., Hays, R. D., Rogers, W., Burnam, M. A., & Judd, L. L. (1994). Subthreshold depression and depressive disorder. Clinical characteristics of general medical and mental health specialty outpatients. American Journal of Psychiatry, 151 (12), 1777–1784.

    Google Scholar 

  • Skinner, H. A. (1982a). The drug abuse screening test. Addictive Behaviors, 7, 363–371.

    Google Scholar 

  • Skinner, H. A. (1982b). The Drug Abuse Screening Test (DAST): Guidelines for administration and scoring. Toronto, OT: Addiction Research Foundation.

    Google Scholar 

  • Skinner, H. A., & Horn, J. L. (1984). Alcohol Dependence Scale (ADS) user's guide. Toronto, OT: Addiction Research Foundation.

    Google Scholar 

  • Spielberger, C.D. (1983). The State–Trait Anxiety Inventory manual. California: Mind Garden.

    Google Scholar 

  • Spitzer, R., Williams, J. B., Kroenke, K., Linzer, M., DeGruy Verloin, F., Hahn, S. R., Brody, D., & Johnson, J. G. (1994). Utility of a new procedure for diagnosing mental disorders in primary care. JAMA, 272 (22), 1749–1756.

    Google Scholar 

  • Steer, R. A., Cavalieri, T. A., Leonard,D. M., & Beck, A. T. (1999). Use of the Beck Depression Inventory for primary care to screen for major depression disorders. General Hospital Psychiatry, 21 (2), 106–111.

    Google Scholar 

  • Stoessel, P.W., Bystritsky, A., & Pasnau, R.O. (1995). Screening for anxiety disorders in the primary care setting. Family Practice, 12 (4), 448–451.

    Google Scholar 

  • Teitelbaum, M. L. (1996). Psychological response to illness. In J. D. Stobo, D. B. Hellman, P. W. Ladenson, B. G. Petty, & T. A. Traill, (Eds.), The principles and practice of medicine (23rd ed., pp. 946–948.) Connecticut: Appleton & Lange.

    Google Scholar 

  • Watson, D., & Kendall, P. C. (1989). Understanding anxiety and depression: Their relation to negative and positive affective states. In P. C. Kendall, & D. Watson (Eds.), Anxiety and Depression: Distinctive and Overlapping Features. Academic Press, San Diego.

    Google Scholar 

  • Zimmerman, M., Farber, N. J., Hartung, J., Lush, D. T., & Kuzma, M. A. (1994). Screening for psychiatric disorders in medical patients: A feasibility and patient acceptance study. Medical Care, 32 (6), 603–608.

    Google Scholar 

  • Zung, W. W. (1990). The role of rating scales in the identification and management of the depressed patient in the PC setting. Journal of Clinical Psychiatry, 51 (6), 72–76.

    Google Scholar 

  • Zung, W.W., Broadhead, W. E., & Roth, M. E. (1993). Prevalence of depressive symptoms in primary care. Journal of Family Practice, 37 (4), 337–44.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Staunton Clinic, Psychology Department, Allegheny University of the Health Sciences, 720 Blackburn Road, Sewickley Valley Hospital, Sewickley, Pennsylvania, 15143

    Francis R. Kush

Authors
  1. Francis R. Kush
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kush, F.R. Primary Care and Clinical Psychology: Assessment Strategies in Medical Settings. Journal of Clinical Psychology in Medical Settings 8, 219–228 (2001). https://doi.org/10.1023/A:1011973027283

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011973027283

Search

Navigation