Assessing the competence of general practitioners in diagnosing generalized anxiety disorder using standardized patients

• Published in: Medical education Vol. 28; no. 5; p. 432
• Main Authors: Shahabudin, S H, Almashoor, S H, Edariah, A B, Khairuddin, Y
• Format: Journal Article
• Language: English
• Published: England 01.09.1994
• Subjects: Anxiety Disorders - diagnosis; Clinical Competence; Family Practice; Humans; Malaysia; Medical History Taking; Patient Simulation; Physician-Patient Relations; Malaysia
• ISSN: 0308-0110
• DOI: 10.1111/j.1365-2923.1994.tb02554.x

The competence of general practitioners (GPs) in diagnosing anxiety neurosis was assessed using standardized patients (SPs) unknown to the doctors. Out of a computer-generated random sample of 100 general practitioners in Kuala Lumpur, 42 volunteered to participate in the study. The results showed that the GPs can be divided into three groups: group A made the correct diagnosis and informed the SPs about their condition (11.9%); group B prescribed tranquillizers and did not inform the SPs of the actual diagnosis but instead said that they were either normal or were suffering from some stress (28.6%); and group C made various diagnoses of physical disorder or did not detect any abnormality at all (59.5%). Thus about 40% of the doctors considered an emotion-related disorder and only 12% of the doctors were confident enough to make and inform the patient of the actual diagnosis. Group A significantly (P < 0.001) asked higher numbers of relevant questions in the signs and symptoms section of the history than the other two groups. No differences between the three groups were observed in the other two sections of history-taking (personality, family, social and precipitating factors), in the general and specific physical examination and interpersonal skills. Generally, with the exception of the interpersonal skills section, the doctors performed less than 40% of the expected tasks in every section. The study highlighted the lack of competence in making a definite diagnosis of anxiety disorder. Among those who apparently made the diagnosis (group B) or made the diagnosis with certainty (group A), there was no demonstration of appropriate treatment behaviour with respect to pharmacological intervention.