Common mental disorders in clinical practice

Abstract

Background: The prevalence of mental disorders in the general population and primary care is high, placing general practitioners as the main gatekeepers for identification, screening, treatment and referral of patients with psychiatric disorders. Therefore, knowing such conditions is mandatory to decrease the morbidity of mental disorders. Purpose: The aim of this article is to review the main issues related to three prevalent mental conditions: mood disorders, anxiety disorders and somatoform disorders. Results: Primary care physicians should screen for depressive disorders (life-time prevalence: 17%) by asking on depressive mood and anhedonia. Bipolar disorders (3-5%) should be ruled out before diagnosing unipolar depressive disorder, as mis diagnosis can increase morbidity. Mood disorders, as well as anxiety disorders (8%), can be safely managed today with several antidepressant drugs. On the other hand, somatoform disorders (6%) require a combined physician-psychiatrist follow-up – in such cases, the physician should recognize the disorder as well as rule out organic diseases. Conclusion: General practitioners can and should manage common psychiatric disorders in their practice; however, they should also be able to recognize more severe conditions whose management should be taken by a psychiatrist.