MENTAL-DISORDERS IN PRIMARY-CARE SERVICES - AN UPDATE

Frank mental disorders, such as depression and panic disorder, are pre valent in primary care; they cause people substantial suffering and in terfere with daily functioning. Even subthreshold or ''subsyndromal'' conditions, with fewer symptoms than necessary for making a diagnosis, cause substantial morbidity. Recent literature on mental disorders in primary care, where many, if not most, people with mental health prob lems are seen, is reviewed with focus on recognition and diagnosis iss ues, management of these problems in primary care, obstacles to accura te diagnosis and appropriate treatment, and prevention issues. In addi tion to a review of recent research, there is an effort to place these topics in the context Of various directives, including research and F ederal documents, that have direct implications for better treatment i n primary care of people with mental disorders (for example, practice guidelines). Mental health problems and disorders seen in primary care are a public health problem meriting immediate attention and substant ial work at many levels-clinical, educational, organizational, and bud getary.