Original Article

Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals


Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years) referred by their primary general practitioners (GPs) to an Urgent Referral Team (URT) based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays) for rapid assessments and early interventions to the outpatients referred by their primary family doctors.
Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.
Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.
Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16: 606-613.

Toft T, Fink P, Oernboel E, Christensen K, Frostholm L, Olesen F. Mental disorders in primary care: prevalence and co-morbidity among disorders. results from the functional illness in primary care (FIP) study. Psychol Med 2005; 35: 1175-1184.

Druss BG. The mental health/primary care interface in the United States: history, structure, and context. Gen Hosp Psychiatry 2002; 24: 197-202.

Verhaak PF, Hoeymans N, Garssen AA, Westert GP. Mental health in the Dutch population and in general practice: 1987-2001. Br J Gen Pract 2005; 55: 770-775.

Borowsky SJ, Rubenstein LV, Meredith LS, Camp P, Jackson-Triche M, Wells KB. Who is at risk of nondetection of mental health problems in primary care? J Gen Intern Med 2000; 15: 381-388.

Singh GP, Chavan BS, Arun P, Sidana A. Seasonal pattern of psychiatry service utilization in a tertiary care hospital. Indian J Psychiatry 2007; 49: 91-95.

Farrokhi F, Mahmoudi-Hamidabad A. Rethinking convenience sampling: Defining quality criteria. Theory and practice in language studies 2012; 2: 784-792.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry 1961; 4: 561-571.

Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: the hopelessness scale. J Consult Clin Psychol 1974; 42: 861-865.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361-370.

Zung WW. A rating instrument for anxiety disorders. Psychosomatics 1971; 12: 371-379.

Zanarini MC, Vujanovic AA, Parachini EA, Boulanger JL, Frankenburg FR, Hennen J. Zanarini Rating Scale for Borderline Personality Disorder (ZAN-BPD): a continuous measure of DSM-IV borderline psychopathology. J Pers Disord 2003; 17: 233-242.

Schifferdecker KE, Reed VA. Using mixed methods research in medical education: basic guidelines for researchers. Med Educ 2009; 43: 637-644.

Spratt C, Walker R, Robinson B. Module A5: Mixed research methods. Commonwealth of Learning 2004.

Wood DM, Dargan PI. Understanding how data triangulation identifies acute toxicity of novel psychoactive drugs. J Med Toxicol 2012; 8: 300-303.

Wilson CE. Triangulation: the explicit use of multiple methods, measures, and approaches for determining core issues in product development. interactions 2006; 13: 46.

Bhugra D, Till A. Public mental health is about social psychiatry. Int J Soc Psychiatry 2013; 59: 105-106.

Miller BF, Teevan B, Phillips RL, Jr., Petterson SM, Bazemore AW. The importance of time in treating mental health in primary care. Fam Syst Health 2011; 29: 144-145.

McCrone P, Dhanasiri S, Patel A, et al. Paying the price: the cost of mental health care in England. London: King’s Fund; 2008.

IssueVol 11 No 4 (2016) QRcode
SectionOriginal Article(s)
Depression Personality Disorders Primary Health Care Psychopathology Suicide

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
McLenan J, Lazzari C, McMillan G, Mackie R. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals. Iran J Psychiatry. 2016;11(4):201-205.