Abstract

Objective: This study aimed to evaluate family physicians’ confidence and competence in diagnosing and managing the most common mental illnesses in the primary healthcare centers (PHC) settings in Saudi Arabia.
Methods: A cross-sectional study surveyed 493 family physicians across various cities in Saudi Arabia, conducted from July 2025 to November 2025. The study was conducted by an online survey using Google Forms to measure self-reported confidence in diagnosing and managing major depressive disorder, general anxiety disorder, panic disorder, and premenstrual syndrome using an eight-item Likert scale. Scores were collected regarding perceived tool utilization, familiarity, and the application of validated screening tools, specifically the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Panic Disorder Severity Scale-self-report (PDSS-SR), and Premenstrual Symptoms Screening Tool (PMSS).
Results: Overall confidence score was moderate (median 26/40, IQR 22–31). Major depressive disorder had the highest level of confidence, with 51.7% in diagnosis and 55.8% in management. The PHQ-9 and GAD-7 scales were the most recognized assessment tools. Moreover, higher professional levels were predictors of increased knowledge and familiarity with these tools (p < 0.001). 3Conclusion: Saudi family physicians demonstrated moderate confidence in managing mental illnesses, with significant gaps noted in smaller cities. Improving mental healthcare delivery requires distributing resources fairly and incorporating organized psychiatric training into PHCs.

Key words: Family physicians, confidence, competence, diagnosis, management, mental illnesses, primary healthcare settings, Saudi Arabia