Chapter 20. Mental and General Health Comorbidities in Persons Presenting in Primary Care

  1. Ihsan M. Salloum Professor of Psychiatry Director3,4 and
  2. Juan E. Mezzich Professor of Psychiatry Director Past President5,6
  1. Michael S. Klinkman Professor1 and
  2. Linda Gask2

Published Online: 11 MAY 2009

DOI: 10.1002/9780470743485.ch20

Psychiatric Diagnosis: Challenges and Prospects

Psychiatric Diagnosis: Challenges and Prospects

How to Cite

Klinkman, M. S. and Gask, L. (2009) Mental and General Health Comorbidities in Persons Presenting in Primary Care, in Psychiatric Diagnosis: Challenges and Prospects (eds I. M. Salloum and J. E. Mezzich), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470743485.ch20

Editor Information

  1. 3

    Division of Alcohol and Substance Abuse: Treatment and Research, University of Miami Miller School of Medicine, FL, USA

  2. 4

    Section on Classification, Diagnostic Assessment and Nomenclature, World Psychiatric Association, FL, USA

  3. 5

    International Center for Mental Health and Division of Psychiatric Epidemiology, Mount Sinai School of Medicine, New York University, NY, USA

  4. 6

    World Psychiatric Association, USA

Author Information

  1. 1

    Departments of Family Medicine and Psychiatry, University of Michigan, MI, USA

  2. 2

    Divisions of Psychiatry and Primary Care, University of Manchester, UK

Publication History

  1. Published Online: 11 MAY 2009
  2. Published Print: 27 MAR 2009

Book Series:

  1. World Psychiatric Association Evidence and Experience in Psychiatry Series

Book Series Editors:

  1. Helen Herrman

Series Editor Information

  1. WPA Secretary for Publications, University of Melbourne, Australia

ISBN Information

Print ISBN: 9780470725696

Online ISBN: 9780470743485



  • mental and general health comorbidities - persons presenting in primary care;
  • primary health care, main point of entry to formal health care;
  • ‘medically unexplained symptoms’ (MUS);
  • Hamilton Rating Scale for Depression;
  • primary care patients, entering formal health care system with multiple undifferentiated and unfiltered symptoms;
  • somatization in primary care;
  • chronic diseases and mood and anxiety disorders


This chapter contains sections titled:

  • Introduction

  • The ‘Context’ in Which Primary Care Services are Delivered

  • The Complex Relationship Between Physical, Mental and Social Problems in Primary Care Patients

  • Problems with the Concept of Psychiatric ‘Caseness’ in Primary Care

  • The Most Common Mental Health Comorbidities in Patients Presenting in Primary Care

  • Mental Health and General Medical Comorbidities

  • Conclusion

  • References