ASSESSING THE COMPETENCE OF GENERAL-PRACTITIONERS IN DIAGNOSING GENERALIZED ANXIETY DISORDER USING STANDARDIZED PATIENTS

The competence of general practitioners (GPs) in diagnosing anxiety ne urosis was assessed using standardized patients (SPs) unknown to the d octors. Out of a computer-generated random sample of 100 general pract itioners in Kuala Lumpur, 42 volunteered to participate in the study. The results showed that the GPs can be divided into three groups: grou p A made the correct diagnosis and informed the SPs about their condit ion (11.9%); group B prescribed tranquillizers and did not inform the SPs of the actual diagnosis but instead said that they were either nor mal or were suffering from some stress (28.6%); and group C made vario us diagnoses of physical disorder or did not detect any abnormality at all (59.5%). Thus about 40% of the doctors considered an emotion-rela ted disorder and only 12% of the doctors were confident enough to make and inform the patient of the actual diagnosis. Group A significantly (P < 0.001) asked higher numbers of relevant questions in the signs a nd symptoms section of the history than the other two groups. No diffe rences between the three groups were observed in the other two section s of history-taking (personality, family, social and precipitating fac tors), in the general and specific physical examination and interperso nal skills. Generally, with the exception of the interpersonal skills section, the doctors performed less than 40% of the expected tasks in every section. The study highlighted the lack of competence in making a definite diagnosis of anxiety disorder. Among those who apparently m ade the diagnosis (group B) or made the diagnosis with certainty (grou p A), there was no demonstration of appropriate treatment behaviour wi th respect to pharmacological intervention. One of the contributory fa ctors could be inadequate knowledge about the signs and symptoms of th e illness as well as current knowledge about the disorder.