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Journal of Public Health Medicine 24:326-331 (2002)
© 2002 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom

The ability of general practitioners to detect mental disorders among primary care patients in a stressful environment: Gaza Strip


Abdel-hamid Afana
Odd Steffen Dalgard
Espen Bjertness
Berthold Grunfeld

Gaza Community Mental Health Programme, The Gaza Strip, Gaza City, PO Box 1049, Palestine. hamid{at}gcmhp.net
Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway.

Background The aim of the present study was to investigate the detection rate by general practitioners (GPs) of mental disorders in a primary health care setting and relating the findings to selected GP characteristics and the patient sociodemographic characteristics.

Methods The patients were assessed with respect to mental disorders by Hopkins Symptom Checklist 25 (HSCL-25), and the GPs were independently asked to fill in the Goldberg checklist II to assess the patient after consultation. The sample consisted of 10 primary health care clinics in the Gaza Strip, which were randomly selected from the five regions that form the Gaza Strip (Northern, Southern region, Gaza City, Middle region, Khan-Younis and Rafah). Thirty-two GPs and 661 patients participated in the study.

Results The study showed that the GPs detected only 11.6 per cent of patients with mental disorders at HSCL-25 score > 1.75, and that the GP's assessment was not significantly associated with the HSCL-25 scores. GPs with postgraduate psychiatric training performed better in detecting mental disorders, likewise female GPs and those who were more than 40 years old. The results also revealed that the GPs were more able to detect mental disorders among patients older than 25 years, and in female patients.

Conclusions The GPs' poor detection rate of mental disorders indicates the importance of mental health training for GPs working in primary health care clinics.

Keywords: GPs, detection of mental disorders, primary health care, stressful environment


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