RECOGNITION OF EMOTIONAL DISTRESS IN PHYSICALLY HEALTHY PRIMARY-CARE PATIENTS WHO PERCEIVE POOR PHYSICAL HEALTH

This study examines the recognition and treatment of emotional distres s in physically healthy primary cave patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three p rivate primary cave practices completed a mental health screening form prior to their medical visit which included an overall assessment of their physical health (1 = excellent, 2 = good, 3 = fair, 4 = poor). F ollowing the visit, their physicians completed a questionnaire that in cluded the same physical health assessment item. The study group, phys ically healthy patients who perceive poor physical health (HPPPH), inc luded those patients who rated their physical health as 2 or 3 points more impaired than it was rated by their physician. HPPPH (N = 39) wer e significantly more likely than other patients (N = 853) to report a prior psychiatric hospitalization (p < 0.05), marital difficulties (p < 0.01), recent missed work due to a mental health problem (p < 0.001) , and a range of anxiety, depressive, and psychosomatic symptoms. Howe ver, HPPPH were also significantly more likely than other patients to receive excellent emotional health ratings (p < 0.001) from their phys icians and were less likely to receive mental health treatment (p < 0. 05). Detection of emotional distress may be particularly difficult in physically healthy patients who have low physical health perceptions. Identification of pessimistic physical health perceptions may serve as an indicator for underlying emotional distress.