Patients' perceptions of the role of the general practitioner in the management of emotional problems

Objectives, To investigate the nature of patients' perceptions of the role of the general practitioner in the management of emotional problems in prim ary care; the association between patient characteristics and perceptions; and the association between perceptions and the recognition of psychiatric morbidity by the GP. Design. Cross-sectional correlation design. Methods. Patients attending their GPs completed the General Health Question naire (N = 1511) and a scale measuring perceptions of the GP's role (the Pa tient Perceptions Scale (PPS), N = 867). Forty-three volunteer GPs assessed patients for psychiatric symptomatology. Self-report and GP assessments of psychiatric status were compared to examine detection of disorder. Results. Principal component analysis of responses to the PPS indicated fou r dimensions. A multilevel model indicated that some of these PPS dimension s were related to patient age, sex and current levels of psychiatric sympto matology. Furthermore, in one dimension there was significant variation at the GP level (i.e. in the average PPS scores between patients consulting di fferent GPs). The likelihood of a patient with significant psychiatric symp toms being recognized was related to the disorder's severity and to the pat ient's perception of the degree to which the GP was oriented to the managem ent of emotional problems. There were no other significant associations wit h the perception questionnaire factors or patient demographic characteristi cs. Conclusions. The perceived role of the GP in the management of emotional pr oblems varies among patients, reflecting both patient characteristics and t he characteristics of their own GP. Perceptions of the orientation of che G P towards emotional issues may influence the likelihood of the recognition of disorder.