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	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 3 No. 10, October 1994   Archives  • Online Features Clinical Review  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal A Review of Unrecognized Mental Illness in Primary Care Prevalence, Natural History, and Efforts to Change the Course Edmund S. Higgins, MD Arch Fam Med. 1994;3(10):908-917. Abstract Studies of the prevalence, natural history, and outcome of unrecognized mental illness in general medical outpatient settings were reviewed. Approximately half of the patients with a psychiatric disorder were not recognized as having a mental illness by their primary care physician. The natural history of unrecognized mental illness suggests a poorer clinical course for anxiety disorders but not for depressive disorders. Most interventions demonstrated a significant improvement in the physician's ability to identify and treat psychiatric disorders but had a minimal effect on patient symptoms and no effect on short-term health care use. Although primary care physicians do not recognize psychiatric disorders in a high percentage of patients, efforts to improve recognition may not lead to decreased patient suffering or decreased health care costs. Author Affiliations From the Departments of Family Medicine and Psychiatry and Behavioral Sciences, the Medical University of South Carolina, Charleston. THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES The Trap of Meaning: A Public Health Tragedy Lyketsos and Chisolm JAMA 2009;302:432-433. FULL TEXT   What Comprises Clinical Experience in Recognizing Depression?: The Primary Care Clinician's Perspective Baik et al. J Am Board Fam Med 2008;21:200-210. ABSTRACT | FULL TEXT   Supporting self-management for patients with complex medical needs: recommendations of a working group Bayliss et al. Chronic Illness 2007;3:167-175. ABSTRACT   Screening for Bipolar Disorder in a Primary Care Practice Das et al. JAMA 2005;293:956-963. ABSTRACT | FULL TEXT   The Recognition of Depression: The Primary Care Clinician's Perspective Baik et al. Ann Fam Med 2005;3:31-37. ABSTRACT | FULL TEXT   Guideline adherence rates and interprofessional variation in a vignette study of depression Tiemeier et al. BMJQS 2002;11:214-218. ABSTRACT | FULL TEXT   Complexity in Late-Life Depression: Impact of Confounding Factors on Diagnosis, Treatment, and Outcomes Kales and Valenstein J Geriatr Psychiatry Neurol 2002;15:147-155. ABSTRACT   Efficacy of Estradiol for the Treatment of Depressive Disorders in Perimenopausal Women: A Double-blind, Randomized, Placebo-Controlled Trial de Novaes Soares et al. Arch Gen Psychiatry 2001;58:529-534. ABSTRACT | FULL TEXT   The Cost-Utility of Screening for Depression in Primary Care Valenstein et al. ANN INTERN MED 2001;134:345-360. ABSTRACT | FULL TEXT   Primary Care Role in the Management of Childhood Depression: A Comparison of Pediatricians and Family Physicians Rushton et al. Pediatrics 2000;105:957-962. ABSTRACT | FULL TEXT   Validation and Utility of a Self-report Version of PRIME-MD: The PHQ Primary Care Study Spitzer et al. JAMA 1999;282:1737-1744. ABSTRACT | FULL TEXT   Consensus Statement on the Upcoming Crisis in Geriatric Mental Health: Research Agenda for the Next 2 Decades Jeste et al. Arch Gen Psychiatry 1999;56:848-853. ABSTRACT | FULL TEXT   Primary Care Physicians' Approach to Depressive Disorders: Effects of Physician Specialty and Practice Structure Williams et al. Arch Fam Med 1999;8:58-67. ABSTRACT | FULL TEXT   Management of Patients With Depression by Rural Primary Care Practitioners Hartley et al. Arch Fam Med 1998;7:139-145. ABSTRACT | FULL TEXT   The 'Usual Care' of Depression Is Not 'Good Enough' Higgins Arch Fam Med 1997;6:340-341. ABSTRACT   Impact of Screening for Mental Health Concerns on Health Service Utilization and Functional Status in Primary Care Patients Reifler et al. Arch Intern Med 1996;156:2593-2599. ABSTRACT   Unrecognized Mental Illness in Primary Care Samuelson Arch Fam Med 1995;4:581-581. ABSTRACT   Brief Diagnostic Interviews (SDDS-PC) for Multiple Mental Disorders in Primary Care: A Pilot Study Weissman et al. Arch Fam Med 1995;4:220-227. ABSTRACT   The Blues: Now and Forever More? Bowman Arch Fam Med 1995;4:95-96. ABSTRACT   Unnrecognized Mental Illness in Primary Care: Another Day and Another Duty in the Life of a Primary Care Physician Glasser and Stearns Arch Fam Med 1994;3:862-864. ABSTRACT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1994 American Medical Association. All Rights Reserved.