Objectives: To assess the frequency of the most frequently observed psychotic-like symptoms in adults consulting general practitioners and to describe their principal characteristics and management.
Methods: Observational epidemiologic survey of 1200 randomly selected general practitioners, distributed throughout France. The symptoms considered were those modified from the BPRS (Brief Psychiatric Rating Scale). During the two-week survey, practitioners recorded the total number of children and adults consulting them and the number with psychotic-like symptoms. They described the characteristics and management of the first three adults with these symptoms (chronological selection).
Results: The mean rate of adults with psychotic-like symptoms was 4.9 +/- 8.1% (95% confidence interval: 4.4, 5.4%) during the 12 618 consultation days assessed. The mean age of these patients was 52 years, with equal numbers of men and women. At the consultation, 18.6% were disabled or on short-term sick-leave from work because of the psychiatric disorder; 35.3% of the patients had no known history of psychiatric disorders. Nearly all these patients (95.2%) had more than one psychotic-like symptom. The principal such symptoms were: "changes in behavior, presentation, or interpersonal relations" (62.0%), "bizarre behavior" (48.2%), "depression" and "anxiety" (49.7 and 42.2%), "unusual thought content" or "conceptual disorganization" (29.3 and 26.9%). Most patients received outpatient pharmaceutical management.
Conclusion: We observed a greater frequency of psychotic-like symptoms in adults consulting general practitioners than expected.