Behavioral and Psychiatric Problems

  • Michael K. Magill
  • Robert W. Garrett


Several studies have found that approximately 15% of the people in the United States experience Psychiatric problems per year.1 For example, a study of three metropolitan areas (New Haven, Baltimore, and St. Louis) found that 13.7 to 15.2% of interviewees met diagnostic criteria for the presence of a Psychiatric disorder within the previous 12 months and 23.0 to 25.2% within their lifetime.2


Anxiety Disorder Family Physician Personality Disorder Panic Attack Psychiatric Problem 


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  1. 1.
    Regier DA, Goldberg ID, Taube CA. The de facto US mental health services system. Arch Gen Psychiatry 1978; 35: 685–93.PubMedCrossRefGoogle Scholar
  2. 2.
    Myers JK, Weissman MM, Tischler GL, et al. Six-month preva-lence of Psychiatric disorders in three communities. Arch Gen Psychiatry 1984; 41: 959–67.PubMedCrossRefGoogle Scholar
  3. 3.
    Houpt JL, Orleans CS, George LK, Brodie HKH. The role of Psychiatric and behavioral factors in the practice of medicine. Am J Psychiatry 1980; 137: 37–47.PubMedGoogle Scholar
  4. 4.
    Marsland DW, Wood M. Mayo F. Data bank for patient care, curriculum, and research in family practice: 526,196 patient problems. J Fam Pract 1976; 3: 25–8.PubMedGoogle Scholar
  5. 5.
    Ransom DC. A quiet revolution going on. Fam Med 1985; 17: 119–20.PubMedGoogle Scholar
  6. 6.
    Carmichael LP, Carmichael JS. The relational model in family practice. Marriage Fam Rev 1981; 4: 123–33.CrossRefGoogle Scholar
  7. 7.
    Szasz TS, Hollender MH. A contribution to the philosophy of medicine: the basic models of the doctor-patient relationship. Arch Intern Med 1956; 97: 585–92.CrossRefGoogle Scholar
  8. 8.
    Hull J. Community physicians: perceptions of their role in treating Psychiatric disorders. Int J Psychiatry Med 1980–81; 10: 921.Google Scholar
  9. 9.
    Kahana RJ, Bibring GL. Personality types in medical management. In: Zinberg E, ed. Psychiatry and medical practice in a general hospital. New York: International Universities Press, 1964.Google Scholar
  10. 10.
    American Psychiatric Association. Diagnostic and Statistical man-ual of mental disorders. 3rd ed. Washington, DC: American Psychiatric Association, 1980.Google Scholar
  11. 11.
    Jones KR, Vischi TR. Impact of alcohol, drug abuse and mental health treatment on medical care utilization—a review of research literature. Med Care 1979;17(suppl):l-82.Google Scholar
  12. 12.
    Taylor, JB. The psychiatrist and the general practitioner. Arch Gen Psychiatry 1961; 5: 23–8.CrossRefGoogle Scholar
  13. 13.
    STFM Task Force on Behavioral Science. Behavioral science in family medicine residencies. I. Teachers and curricula. Fam Med 1985; 17: 64–73.Google Scholar
  14. 14.
    Goldberg RJ, Wise TN. Where is psychiatry in primary medical care training? Psychosomatics 1985; 26: 882–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Wise TN, Mann LS, Berlin RM, Berenbaum I. Mental health referral patterns by family medicine educators. Compr Psychiatry 1984; 25: 464–9.CrossRefGoogle Scholar
  16. 16.
    Smith GR, Monson RA, Ray DC. Psychiatric consultation in somatization disorder: a randomized controlled study. N Engl J Med 1986; 314: 1407–13.PubMedCrossRefGoogle Scholar
  17. 17.
    Medalie J. The family life cycle and its implications for family practice. J Fam Pract 1979; 9: 47–56.PubMedGoogle Scholar
  18. 18.
    Smilkstein G. The cycle of family function: a conceptual model for family medicine. J Fam Pract 1980; 2: 223–32.Google Scholar
  19. 19.
    Enelow AJ. Elements of psychotherapy. New York: Oxford University Press, 1982.Google Scholar
  20. 20.
    Cameron OG. Differential diagnosis of anxiety. Psychiatr Clin North Am 1985; 8: 3–23.PubMedGoogle Scholar
  21. 21.
    Marks I, Griest JH, Jefferson JH, Spitzer RL. Anxiety disorders. In: Treatment of mental disorders. New York: Oxford University Press, 1982.Google Scholar
  22. 22.
    Leibowitz MR. Imipramine in the treatment of panic disorder and its complications. Psychiatr Clin North Am 1985; 8: 37–47.Google Scholar
  23. 23.
    Sheehan DV. Monoamine oxidase inhibitors and alprazolam in the treatment of panic disorder and agoraphobia. Psychiatr Clin North Am 1985; 8: 49–62.PubMedGoogle Scholar
  24. 24.
    Murphy JM, Sobol AM, Neff RK, et al. Stability of prevalence— depression and anxiety disorders. Arch Gen Psychiatry 1984; 41: 990–7.PubMedCrossRefGoogle Scholar
  25. 25.
    Blumenthal MD, Dielman TE. Depressive symptomatology and role function in a general population. Arch Gen Psychiatry 1975; 32: 985–91.PubMedCrossRefGoogle Scholar
  26. 26.
    Weissman MM, Myers JK. Rates and risks of depressive symptoms in a United States urban Community. Arch Psychiatr Scand 1978; 57: 219–31.CrossRefGoogle Scholar
  27. 27.
    Nielsen AC, Williams TA. Depression in ambulatory medical patients. Arch Gen Psychiatry 1980; 37: 999–1004.PubMedCrossRefGoogle Scholar
  28. 28.
    Justin RG. Incidence of depression in one family physician’s practice. J Fam Pract 1976; 3: 438–9.PubMedGoogle Scholar
  29. 29.
    Wright JH, Bell RA, Kuhn CC, et al. Depression in family practice patients. South Med J 1980; 73: 1031–4.PubMedCrossRefGoogle Scholar
  30. 30.
    Raft D, Spencer RF, Toomey T, Brogan D. Depression in medical outpatients—use of the Zung scale. Dis Nerv Syst 1977; 38: 999–1004.PubMedGoogle Scholar
  31. 31.
    Linn LS, Yager J. The effect of Screening, sensitization, and feed-back on notation of depression. J Med Educ 1980; 55: 943–9.Google Scholar
  32. 32.
    Salkind MR. Beck depression inventory in general practice. J R Coli Gen Pract 1969; 18: 267–71.Google Scholar
  33. 33.
    Glass RM, Allan AT, Uhlenhugh EH, et al. Psychiatric Screening in a medical clinic: an evaluation of a self-report interview. Arch Gen Psychiatry 1978; 35: 1189–95.PubMedCrossRefGoogle Scholar
  34. 34.
    Hollister LE. Clinical pharmacology of psychotherapeutic drugs. 2nd ed. New York: Churchill Livingstone, 1983.Google Scholar
  35. 35.
    Beck AT, Ward CH, Mendelson M, et al. An inventory for mea-suring depression. Arch Gen Psychiatry 1961; 4: 53–63.CrossRefGoogle Scholar
  36. 36.
    Zung WWK. A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63–70.PubMedCrossRefGoogle Scholar
  37. 37.
    Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62.PubMedCrossRefGoogle Scholar
  38. 38.
    Carroll BJ, Fielding JM, Blashki TG. Depression rating scales—a critical review. Arch Gen Psychiatry 1973; 28: 361–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Schnurr R, Hoaken PCS, Jarrett FJ. Comparison of depression inventories in a clinical population. Can Psychiatr Assoc J 1976; 21: 473–6.PubMedGoogle Scholar
  40. 40.
    Schaefer A, Brown J, Watson CG, et al. Comparison of the validi-ties of the Beck, Zung, and MMPI depression scales. J Consult Clin Psychol 1985; 53: 415–18.PubMedCrossRefGoogle Scholar
  41. 41.
    Hedlund JL, Vieweg BW. The Zung self-rating depression scale— a comprehensive review. J Operational Psychiatry 1979; 10: 51–64.Google Scholar
  42. 42.
    Biggs JT, Wylie LT, Zeigler VE. Validity of the Zung self-rating depression scale. Br J Psychiatry 1978; 132: 381–5.PubMedCrossRefGoogle Scholar
  43. 43.
    Boyle GJ. Self-report measures of depression—some psychome-tric considerations. Br J Clin Psychol 1985; 24: 45–59.PubMedCrossRefGoogle Scholar
  44. 44.
    Moore JT, Silimperi DR, Bobula JA. Recognition of depression by family medicine residents: the impact of Screening. J Fam Pract 1978; 7: 509–13.PubMedGoogle Scholar
  45. 45.
    Magill MK, Zung WWK. Clinical decisions about diagnosis and treatment for depression identified by Screening. J Fam Pract 1982; 14: 1144–9.PubMedGoogle Scholar
  46. 46.
    Arons SF, Frances AJ, Mann JJ. Atypical depression—a review of diagnosis and treatment. Hosp Commun Psychiatry 1985; 36: 275–82.Google Scholar
  47. 47.
    Rush AJ, ed. Short-term psychotherapies for depression: behavioral, interpersonal, cognitive, and psychodynamic approaches. New York: Guilford Press, 1982.Google Scholar
  48. 48.
    Beck AT, Rush AJ, Shaw B, Emergy G. Cognitive therapy of depression. New York: Guilford Press, 1979.Google Scholar
  49. 49.
    American Psychiatric Association task force on the use of laboratory tests in psychiatry. Tricyclic antidepressants—blood level measurements and clinical outcome: an APA task force report. Am J Psychiatry 1985; 142: 155–62.Google Scholar
  50. 50.
    Richardson JW III, Richelson E. Antidepressants—a clinical update for medical practitioners. Mayo Clin Proc 1984; 59: 330–7.PubMedCrossRefGoogle Scholar
  51. 51.
    Prien RF, Blaine JD, Levine J. Antidepressant drug therapy—the role of the new antidepressants. Hosp Commun Psychiatry 1985; 36: 513–16.Google Scholar
  52. 52.
    Pare CBM. The present status of monoamine oxidase inhibitors. Br J Psychiatry 1985; 146: 576–84.PubMedCrossRefGoogle Scholar
  53. 53.
    Rosenbaum AH, Maruta T, Richelson E. Series of pharmacology in clinical practice I. Drugs that alter mood. II. Lithium. Mayo Clin Proc 1979; 54: 401–7.Google Scholar
  54. 54.
    Frankel FH. Electroconvulsive therapy. In: Frankel FH, ed. The Psychiatric therapies. Washington, DC: American Psychiatric Association, 1984.Google Scholar
  55. 55.
    Groves JG. Taking care of the hateful patient. N Engl J Med 1978; 298: 883–7.PubMedCrossRefGoogle Scholar
  56. 56.
    Groves JG. Borderline personality disorder. N Engl J Med 1981; 305: 259–62.PubMedCrossRefGoogle Scholar
  57. 57.
    Kernberg OF. Structural interviewing. Psychiatr Clin North Am 1981; 4: 169–95.PubMedGoogle Scholar
  58. 58.
    Gardner DL, Cowdry RW. Suicidal and parasuicidal behavior in borderline personality disorder. Psychiatr Clin North Am 1985; 8: 389–403.PubMedGoogle Scholar
  59. 59.
    Rinsley DB. Dynamic and developmental issues in borderline and related “spectrum” disorder. Psychiatr Clin North Am 1981; 4: 117–32.PubMedGoogle Scholar
  60. 60.
    Mahler MS, Pine F, Bergman A. The psychological birth of the human infant: symbiosis and individuation. New York: Basic Books, 1975.Google Scholar
  61. 61.
    Gunderson JG, Englund DW. Characterizing the families of bor-derlines—a review of the literature. Psychiatr Clin North Am 1981; 4: 159–168.PubMedGoogle Scholar
  62. 62.
    Stoudemire A, Thompson TL. The borderline personality in the medical setting. Ann Intern Med 1982; 96: 76–9.PubMedCrossRefGoogle Scholar
  63. 63.
    Quill TE. Partnerships in patient care: a contractual approach. Ann Intern Med 1983; 98: 228–34.PubMedCrossRefGoogle Scholar
  64. 64.
    Akiskal HS, Chen SE, Davis GC, et al. Borderline: an adjective in search of a noun. J Clin Psychiatry 1985; 46 (2): 41–8.PubMedGoogle Scholar
  65. 65.
    Loranger AW, Oldham JM, Russakoff LM, et al. Structured inter-views and borderline personality disorder. Arch Gen Psychiatry 1984; 41: 565–8.PubMedCrossRefGoogle Scholar
  66. 66.
    Edell WS. The borderline Syndrome index: clinical validity and Utility. J Nerve Ment Dis 1984; 172: 254–63.CrossRefGoogle Scholar
  67. 67.
    Perry JC, Klerman GL. The borderline patient: a comparative analysis of four sets of diagnostic criteria. Arch Gen Psychiatry 1978; 35: 141–50.PubMedCrossRefGoogle Scholar
  68. 68.
    Kroll J, Sines L, Martin K, et al. Borderline personality disorder: construct validity of the concept. Arch Gen Psychiatry 1981; 38: 1021–6.PubMedCrossRefGoogle Scholar
  69. 69.
    Nelson HF, Tennen H, Tasman A, et al. Comparison of three systems for diagnosing borderline personality disorder. Am J Psychiatry 1985; 142: 855–8.PubMedGoogle Scholar
  70. 70.
    McGlashan TH. The borderline Syndrome. I. Testing three diagnostic systems. Arch Gen Psychiatry 1983; 40: 1311–18.PubMedCrossRefGoogle Scholar
  71. 71.
    Anstett R. The difficult patient in the physician-patient relationship. J Fam Pract 1980; 11: 281–286.PubMedGoogle Scholar
  72. 72.
    Reiser DE, Levenson H. Abuses of borderline diagnosis: a clinical problem with teaching opportunities. Am J Psychiatry 1984; 141: 1528–32.PubMedGoogle Scholar
  73. 73.
    Robins LN, Heizer JE, Weissman MM, et al. Lifetime prevalence of specific Psychiatric disorders in three sites. Arch Gen Psychiatry 1984; 41: 949–58.PubMedCrossRefGoogle Scholar
  74. 74.
    Smith RC: A clinical approach to the somatizing patient. J Fam Pract 1985; 4: 294–301.Google Scholar
  75. 75.
    Folstein ME, Folstein SE, McHugh PR. The mini-mental State: a practical method for grading the cognitive State of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.PubMedCrossRefGoogle Scholar
  76. 76.
    Jacobs JW, Bernhard MR, Delgado A, Strain JJ. Screening for organic mental syndromes in the medically ill. Ann Intern Med 1977; 86: 40–6.PubMedCrossRefGoogle Scholar
  77. 77.
    Karacan I, Salis PJ. Diagnosis and treatment of erectile impo-tence. Psychiatr Clin North Am 1980; 3: 97–111.Google Scholar
  78. 78.
    Virag R, Bouilly P, Frydman D. Is impotence an arterial disorder? A study of arterial risk factors in 440 impotent men. Lancet 1985; 1: 181–84.PubMedCrossRefGoogle Scholar
  79. 79.
    Annon JS. Behavioral treatment of sexual problems. New York: Harper & Row, 1976.Google Scholar
  80. 80.
    Masters WH, Johnson VE. Human sexual inadequacy. Boston: Little, Brown, 1970.Google Scholar
  81. 81.
    Kaplan HS. The new sex therapy. New York: Bruner/Mazel, 1974.Google Scholar
  82. 82.
    Compernolle T, Hoogduin K, Joele L. Diagnosis and treatment of the hyperventilation Syndrome. Psychosomatics 1979; 20: 612–25.PubMedCrossRefGoogle Scholar
  83. 83.
    Castelnuovo-Tedesco P. The twenty-minute hour. Boston: Little, Brown, 1965.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Michael K. Magill
  • Robert W. Garrett

There are no affiliations available

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