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Interviewing Skills Pay Off in Disease Identification

Most primary care outpatients are women, and many suffer from emotional disorders that can complicate the diagnosis and treatment of physical symptoms. This study examined whether the interviewing skills of primary care physicians are correlated with their ability to detect emotional disorders. Researchers taped 10 physicians interviewing 233 patients; the patients were assessed immediately afterward by a psychiatrist using a structured interview.

The accuracy of the diagnosis was not associated with the social, academic, attitudinal, or professional characteristics of the physicians, the sociodemographic characteristics of the patients, the length of time the clinician spent exploring emotional symptoms, or the severity of the patients' medical or emotional disorders. The interviewing skills predictive of accurate diagnosis were active listening (eye contact and face-to-face posture without verbal interruptions) and the ability to ask questions with psychological content. A negative attitude of the physician toward the patient was related inversely to accuracy of diagnosis.

Comment: Increased pressure on primary care physicians' time with patients may make listening skills seem a luxury, but high-quality interviews pay off in the identification of mental disorders that cause pain and consume medical time and other resources. These skills can be learned, and they should be cultivated.

— NL Stotland

Published in Journal Watch Women's Health May 1, 1998

Citation(s):

Giron M et al. Clinical interview skills and identification of emotional disorders in primary care. Am J Psychiatry 1998 Apr 155 530-535.

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