The chronically mentally ill in primary care

The role of primary care physicians in addressing the needs of chronically mentally ill patients is examined from three perspectives: assessing community prevalence; treating chronic medical problems in the context of other human service needs; and treating specific types of chronic mental disorders. About 30% of primary care patients were found to have at least one Research Diagnostic Criteria mental disorder, five-sixths of which had a duration greater than 1 year. However, about 9% of patients had some impairment and 2% had severe impairment associated with a mental disorder. Although affective disorders have the highest overall rates, personality, psychotic, and anxiety disorders contribute the greatest proportion of severe disability.