L’INTERAZIONE MEDICO-PAZIENTE NELLA MEDICINA GENERALE.Definizione di un modello descrittivo dell’intervista medica e delle variabili che contribuiscono al riconoscimento del disagio emotivo nel contesto della medicina generale.

The thesis is based on a study conducted in two phases. During the first phase all the consultations of the patients who came for a new health problem were collected and recorded. During the second phase a case-control staudy was conducted. For the six participating GPs two groups of matched pairs of patients (N¯238) were created. The two groups comprised either patients considered by GPs as being without emotional distress or patients considered as emotionally distressed. Within each pair, one patient was a case (GHQ-12 score "2) and the other was the matched control (GHQ-12 score !3). The medical interviews with these patients were transcribed and classified according to the Verona Medical Interview Classification System (VR-MICS). The thesis permitted to conduct reability studies on the VR-MICS and to analyse the verbal behaviour of patients and doctors during clinical consultations showing that to improve the recognition of those emotionally distressed patients most likely to be missed, GPs should increase their attention to cues related to life style and life episodes..