--- title: "How do PCPs respond when pts cry in outpt visits? | Sutter Health" description: "Although most physicians did express empathy in response to patients’ tears, some did not systematically assess patients’ mental health status and overall functioning. Physicians may want to view crying as a sign of distress and more fully evaluate whether it fits into a more complex clinical presentation of depression." url: "https://www.sutterhealth.org/research/publications/how-pcps-respond-when-pts-cry-in-outpt-visits-1055312766" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. How do PCPs respond when pts cry in outpt visits? # How do primary care physicians respond when patients cry during routine ambulatory visits? Stults CD, Elston Lafata J, Diamond L, MacLean L, Stone AL, Wunderlich T, Frankel RM, & Tai-Seale M. _J Comm Healthcare. 7(1):17-24. DOI: http://dx.doi.org/10.1179/1753807614Y.0000000044_ 2014-03-01 ## Abstract Although crying is universally recognized as a sign of distress in adults, its role in assessing and diagnosing depression in medical settings has received little attention. We sought to describe the interactional circumstances surrounding patients who cry during routine periodic health examinations and the subsequent actions of their physicians. Qualitative content analysis of audio-recorded visits and administrative claims data for adult primary care patients for one year before and after an index visit were used to explore the context of patients’ crying and how physicians responded. Most patients began to cry while discussing emotional pain over the loss or illness of a loved one. While physicians generally responded with immediate expressions of empathy, the intensity of their responses varied. Some patients received minimal assessment regarding their mental health, whereas others were assessed more extensively. Although most physicians did express empathy in response to patients’ tears, some did not systematically assess patients’ mental health status and overall functioning. Physicians may want to view crying as a sign of distress and more fully evaluate whether it fits into a more complex clinical presentation of depression. ![Cheryl Stults, Ph.D.](https://dyn.mktgcdn.com/p/3IhveEwq-t5WoqAzSNGeAr-4g4yrj4v7x1QcPGdCX_s/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Cheryl Stults, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/cheryl-stults-phd-1049681000) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [New Era Of Patient Engagement](https://www.sutterhealth.org/research/publications/new-era-of-patient-engagement-1055312777) Tai-Seale M. Health Affairs website. 2013 Feb 06 - Publication ### [Expressing uncertainty in clinical interactions between physicians and older patients: what matters?](https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608) Tai-Seale M, Stults C, Zhang W, Shumway M. Patient Educ Couns. 86(3):322-8. doi: 10.1016/j.pec.2011.06.005. Epub 2011 Jul 20. 2012 Mar 01 - Publication ### [Two-minute mental health care for elderly patients: inside primary care visits.](https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643) Tai-Seale M, McGuire T, Colenda C, Rosen D, Cook MA. J Am Geriatr Soc. 55(12):1903-11. 2007 Dec 01 - Publication ### [Three types of ambiguity in coding empathic interactions in primary care visits: implications for research and practice.](https://www.sutterhealth.org/research/publications/ambiguity-in-coding-empathic-interactions-in-pc-1055312573) Stone A, Tai-Seale M, Stults C, Luiz J, Frankel R. Patient Educ Couns. 89(1):63-8. doi: 10.1016/j.pec.2012.06.013. Epub 2012 Jul 17. 2012 Oct 01 - Publication ### [Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data.](https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561) Tai-Seale M, Bramson R, Drukker D, Hurwicz ML, Ory M, Tai-Seale T, Street R Jr, Cook MA. Med Care. 43(12):1217-24. 2005 Dec 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/how-pcps-respond-when-pts-cry-in-outpt-visits-1055312766#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"How do PCPs respond when pts cry in outpt visits?"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/how-pcps-respond-when-pts-cry-in-outpt-visits-1055312766#medicalscholarlyarticle","name":"How do primary care physicians respond when patients cry during routine ambulatory visits?","headline":"How do PCPs respond when pts cry in outpt visits?","abstract":"Although crying is universally recognized as a sign of distress in adults, its role in assessing and diagnosing depression in medical settings has received little attention. 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