The psychiatric patient's family and length of hospitalization

Fifteen percent of the general population may experience a major disorder of mood during their lives.1 Their care falls to the greatest degree upon the primary physician.2 A general practitioner may be chosen for the first contact by an estimated 88% of individuals fearing an experiencing psychologic disturbance.3 As many as 63% of community based mentally ill (n = 490,000) may receive their psychiatric treatment from a general practitioner.4 This prevalence is further enhanced by the observation that psychiatric patients represents a high medical utilization group when contrasted with nonpsychiatric controls.5 Since the depressive syndrome is of diverse etiology, and may present under the guise of a physical complaint, a comprehensive evaluation should include a personal and family history, physical and mental status examination, and appropriate laboratory tests. While family practitioners may spend from 17% to 27% of patients care time dealing with emotionally related problems,6 some 60% of the American Academy of Family Physicians reported “insufficient training in medical school” to deal with their patients' emotional problems. A comprehensive data base (Table 1) was contrasted with the practices of second and third year family practice residents by a prospective study of recently diagnosed “depression” at a community primary care center.