Alcohol and substance abuse

Most patients with psychiatric disorders receive their treatment from gener al internists and family physicians. Psychiatric illnesses have been underd iagnosed in primary care settings, caused, in part, to the absence of effic ient methods for identifying patients in need of treatment. Two diagnostic instruments (PRIME-MD and DSM-IV-PC) were introduced in 1994 specifically f or primary care practitioners and their patients. More recent research has suggested that a two-step method consisting of a few probing questions foll owed by a confirmatory examination can rapidly detect common psychiatric il lnesses with acceptable sensitivity and specificity in primary care practic es.