A review of unrecognized mental illness in primary care. Prevalence, natural history, and efforts to change the course

Arch Fam Med. 1994 Oct;3(10):908-17. doi: 10.1001/archfami.3.10.908.


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 of 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.

Publication types

  • Review

MeSH terms

  • Adult
  • Child
  • Controlled Clinical Trials as Topic
  • Humans
  • Mental Disorders / diagnosis*
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Prevalence
  • Primary Health Care / statistics & numerical data*
  • Prognosis
  • United States / epidemiology