Clinical interview skills and identification of emotional disorders in primary care.

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.

[Acceptability, reliability and validity of the Corney and Clare social problems questionnaire]. / Aceptabilidad, fiabilidad y validez del cuestionario de problemas sociales de Corney y Clare.

OBJECTIVE: To evaluate the acceptability, reliability and concurrent validity of the CORNEY and CLARE self-administered social problems questionnaire. DESIGN: Reliability was studied by a test-retest (24 hours). Validity (concordance) was studied through comparison with a standard social adaptation interview. SETTING: Primary Health Care. PATIENTS: Consecutive patients attached to a long-treatment nursing station and 4 medical clinics. MEASUREMENTS AND MAIN RESULTS: The questionnaire consisted of 33 items and evaluated 9 areas of social functioning. In each area, the items covered 2 types of evaluation: problems in objective circumstances or in functioning and level of satisfaction. There were no significant difficulties in the questionnaire's administration. In the test-retest evaluation, there was adequate concordance of the average scores of the items evaluating difficulties and problems. This was not the case for the average scores of the items which evaluated satisfaction. The validity of 28 of the questionnaire's 33 items was examined. A moderate concordance level was found for 11 items on the questionnaire. An average score taken from these items provided a sufficient measurement of tendency regarding the overall seriousness of the subjects' social problems. CONCLUSIONS: The results do not favour the use of this questionnaire as a substitute for standard interviews in the evaluation of specific social problems, but do support the use of part of it in order to obtain a valid tendency measurement.