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Dr Smith describes the dilemma of concerned family and general practitioners regarding mental morbidity in the older patient. He counsels very strongly that training and other approaches intended to increase skills of these practitioners are essential. In this, he shares the concern that motivated the study reported in the Jan 23/30 issue of JAMA, which concludes with the opinion that some strategy aimed at helping the family practitioner is necessary. The General Health Questionnaire, which was used in our study, may not be the most effective strategy, and certainly more investigation is indicated. Better designed and targeted training as well as interventions to increase the awareness of clinicians are both indicated. We join Dr Smith in calling attention to the fact that the elderly do have psychological and emotional problems requiring attention.
German PS. The Family Practitioner and Psychiatric Problems in the Old-Reply. JAMA. 1987;257(17):2293. doi:10.1001/jama.1987.03390170048023