Diagnostic and treatment practices following GHQ feedback

Doctors who examined the General Health Questionnaire (GHQ-28) scores of their patients at feedback had significant (w= 24, n= 6, p<0.05) increase in their tendency to rate the problems of their patients as deserving of treatment. For these doctors the severity rating rose by an average of 18% following feedback. The number and types of diagnosis categories used were similar among doctors within centres but differed between practices. Counselling was the main form of treatment for psychological disorders in the study sites. However, there was a paradoxical reduction in counselling and a rise in psychotropic drug prescription with feedback. When a case was identified as a result of the feedback interview, GHQ was significantly likely (X 2 = 24, 15, df 6, p<0.01) to be described as 'useful', but the instrument was likely (X 2 = 21.52, df 6, p<0.01) to be described as 'not useful' if the case was previously known to the doctor. The implications were highlighted.