Clinical interview skills and identification of emotional disorders in primary care

Am J Psychiatry. 1998 Apr;155(4):530-5. doi: 10.1176/ajp.155.4.530.


Objective: The aim of this research was to study the relationship between the clinical interview skills of primary care physicians and their psychodiagnostic ability during office visits.

Method: Ten doctors took part in the study, and 233 patients were assessed. The patients were seen and diagnosed by their physicians and interviewed afterward by a psychiatrist using the Present State Examination. All the interviews with the primary care physicians were recorded on videotape, and the Physician's Skills Observation Scale was used to analyze 10 interviews per doctor, five psychiatric cases and five nonpsychiatric cases.

Results: The physician's active listening (eye contact, posture, and absence of verbal interruptions) and ability to ask questions with psychological content were associated with the ability to identify the patient's emotional problems. This association was shown to be independent of the physician's characteristics (social, academic, attitudinal, and professional), the sociodemographic characteristics of the patients, the time spent in exploration during the office visit, and the severity of the emotional or somatic disorder.

Conclusions: The findings of this research highlight the need to train primary care physicians in specific interview skills, in order to improve their ability to identify mental disorders in their practices.

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel
  • Clinical Competence* / standards*
  • Educational Status
  • Family Practice / education
  • Family Practice / standards*
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Middle Aged
  • Nonverbal Communication
  • Office Visits
  • Physician-Patient Relations
  • Physicians, Family / education
  • Physicians, Family / standards*
  • Posture
  • Psychiatric Status Rating Scales / standards*
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Severity of Illness Index
  • Time Factors
  • Videotape Recording