RT Journal Article
SR Electronic
T1 Detection of patient psychological distress and longitudinal patient–doctor relationships: a cross-sectional study
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e167
OP e173
DO 10.3399/bjgp12X630052
VO 62
IS 596
A1 Matthew Ridd
A1 Glyn Lewis
A1 Tim J Peters
A1 Chris Salisbury
YR 2012
UL http://bjgp.org/content/62/596/e167.abstract
AB Background Psychological distress in patients who attend their GP is thought to be under-recognised. However, it is likely that both disclosure and detection are influenced by how well the patient and doctor know each another.Aim To examine whether patient–doctor depth of relationship is associated with identification of psychological distress.Design and setting Cross-sectional study in general practices in and around Bristol, England.Method Patients (aged ≥16 years) were asked to complete a questionnaire and consent to their electronic medical records being reviewed. Study GPs independently assessed patient psychological distress. Multivariable logistic regression was used to look for associations between patient–doctor depth of relationship and GP detection of patient psychological distress (defined according to the 12-item General Health Questionnaire, GHQ-12).Results There were 643 eligible appointments with 31 GPs. In total, 541 (84.1%) patients returned questionnaires and 490 (76.2%) consented to their records being reviewed. Patient–doctor depth of relationship was not associated with GP detection of mild to severe patient psychological distress (adjusted odds ratio [OR] 0.94, 95% CI = 0.87 to 1.02) but, in secondary analyses, it was associated with the identification of moderate to severe distress (adjusted OR 1.13, 95% CI = 1.02 to 1.26). GPs reported more patient psychological distress in patients who reported a greater depth of relationship but this did not relate to patients' GHQ-12 scores.Conclusion Evidence to support an association between patient–doctor depth of relationship and improved GP detection of patients with psychological distress was weak, except in those patients who GPs thought were more distressed. GPs may overestimate emotional distress in patients who report deeper patient–doctor relationships.