Gender issues in psychosocial morbidity in general practice

The objective of this study was to compare differences in reasons for encounters, diagnosis and treatment between men and women patients presenting with psychosocial problems as recognised by their general practitioners. The research design was a survey based on structured questionnaires completed by the general practitioners on patients consulting with mental health problems in Bunbury in the rural South West region of Western Australia. The data collection took place for a period of 5 weeks. Twenty two general practitioners, from 5 surgeries, collected information on 428 patients, pertaining to socio-demographic characteristics, reasons for encounter, diagnoses, social problems, chronicity, counselling, medication and use of referral services. The gender differences in the illness profile was quite pronounced. Men patients were older, were more likely to be diagnosed with psychosis or character disorders, to have employment or unknown problems. On the other hand, female patients were younger and more likely not to be given a definite diagnosis, to report more social isolation, dependent/difficult relatives and problems resulting from assault. Men were more likely to be on medication and to be referred to psychiatrists, while women received more counselling from their GPs or were referred to counselling services. On the basis of the findings, it is pointed out that men and women differ in terms of the recognition that they are suffering from a problem, that outside help is needed and making the decision to consult. They also differ in terms of the social factors influencing gender differences in recognition of the illness by the GP and the decision to treat and/or refer.