Assessment of psychiatric illness severity by family physicians

Of the three ratings-self-ratings, evaluation by the treating physician, and a clinical interview by a research psychiatrist-patient and research psychiatrist ratings achieved the highest level of agreement, treating physicians showed the greatest variability.

Abstract

Independent psychiatric illness assessments of family practice patients are compared. Of the three ratings-self-ratings, evaluation by the treating physician, and a clinical interview by a research psychiatrist-patient and research psychiatrist ratings achieved the highest level of agreement (50% of the variance). Of the three kinds of raters, treating physicians showed the greatest variability. Least agreement appeared for Practice Two, upper middle class college town people who were relatively high in interpersonal sensitivity complaints. Most agreement appeared for Practice Three, ghetto inner city people who were relatively high in somatic complaints. The rating performance of treating physicians is attributed to both rating instrument and rating context.