The FIP study: a randomised, controlled trial of screening and recognition of psychiatric disorders.

BACKGROUND Research on questionnaires as screening tools for psychiatric disorders has yielded conflicting results. AIM To examine the effect of a routinely administered questionnaire on recognition of common psychiatric disorders in general practice. DESIGN OF STUDY Randomised controlled trial. SETTING Twenty-eight general practices in Aarhus County, Denmark. METHOD Thirty-eight general practitioners (GPs) and 1785 consecutive patients, aged 18-65 years old, presenting with a new health problem, participated. Before consultation, patients were screened using a brief screening questionnaire (SQ) including somatisation, anxiety, depression, and alcohol abuse scales. Patients were randomised to one of two groups: 900 questionnaires were disclosed and scored by the GPs, 885 were blinded. A stratified subsample of 701 patients was interviewed after the consultation using a standardised psychiatric research interview (SCAN). RESULTS Overall the GPs' recognition rates were 14% (95% confidence interval [CI] = -2 to 30) better for depression and 35% (95% CI = 2 to 68) better for alcohol problems when SQs were disclosed. Recognition rates for anxiety improved 8% (95% CI = -9 to 26) overall. In the case of somatoform disorders, disclosure showed no effect overall. Among those with high SQ scores, however, disclosure increased recognition rates on any mental disorder evaluated. CONCLUSION This study demonstrated limited usefulness for routine screening for common psychiatric disorders. However, findings suggest that the SQ may be useful for case-finding among a subgroup of patients with high SQ scores.