Gender issues in psychosocial morbidity in general practice

The objective of this study was to compare differences in reasons for encou nters, diagnosis and treatment between men and women patients presenting wi th psychosocial problems as recognised by their general practitioners. The research design was a survey based on structured questionnaires complet ed by the general practitioners on patients consulting with mental health p roblems in Bunbury ill the rural South West region of Western Australia. Th e data collection rook place for a period of 5 weeks. Twenty hva general pr actitioners, front 5 surgeries, collected information on 428 patients, pert aining to socio-demographic characteristics, reasons for encounter, diagnos es, social problems, chronicity, counselling, medication and use of referra l services. The gender differences in the illness profile was quite pronounced. Men pat ients were older were more likely to be diagnosed with psychosis or charact er disorders, to have employment or unknown problems. On the other hand, fe male patients were younger and more likely not to be given a definite diagn osis, to report more social isolation, dependent/difficult relatives and pr oblems resulting from assault. Men were more likely to be an medication and to be referred to psychiatrists, while women received more counselling fro m their GPs or were referred to counselling services. On the basis of the findings, it is pointed out that men and women differ i n terms of the recognition that they are suffering from a problem, that out side help is needed and making the decision to consult. They also differ in terms of the social factors influencing gender differences in recognition of the illness by the CP and the decision to treat and/or refer.