Psychiatric morbidity and referral rates in general practices: Comparison of an industrial town and a rural area in West Germany

Summary Samples of the clientele of general practitioners in the industrial city of Mannheim and the county of Traunstein, a small-town-rural area in Upper Bavaria, were interviewed with the Clinical Psychiatric Interview (Goldberg et al. 1970). The prevalence and diagnostic distribution of psychiatric illness among 1.026 patients in Mannheim and 1.274 patients in Traunstein were established. In addition we examined the ability of general practitioners to detect mental disorders among the same patients. The relationship of this factor to the size of the practice and the duration of the doctor-patient relationship was tested. Controlling for sex, age and marital status yielded only minor differences in psychiatric prevalence rates and diagnostic distribution between the two areas. In Mannheim, however, more psychiatric cases identified by the interviewers were detected by the family physicians. In comparison with Traunstein the rate of psychiatric referrals was significantly higher in Mannheim.