This article examines the prevalence and long-term course of psychological disorders in primary care. A random sample of 215 attenders of 25 general practitioners (GPs) was interviewed three times: within two weeks after index-consultation, after one year, and after 3+ years.

At first interview, 31% of the GP attenders met Bedford College criteria for a psychological disorder. In 55% of these cases the cours of the disorders was chronic or chronic-intermittent. The average duration since index-consultation was more than 24 months. In general, the course of depressive disorders was more favourable than the course of anxiety disorders and psychological disorders with anxiety-depression comorbidity.

On the basis of these findings and of a critical evaluation of the literature, the authors conclude that psychogical disorders in primary care have a higher prevalence and a less favourable prognosis than is often assumed. They advocate the development and evaluation of primary care intervention programs directed at early recognition, diagnostic accuracy, and disorder specific treatment.