BACKGROUND Much of teachlng and resean:h has concentrated on single disease entities. In general practice, however, many patients suffer from a number of Interacting Ulnesses at the same time. It is unlikely we' wll1 ever have randomlsed controlled trlaIs to gulde the management of such patients. OBJECTIVE This article alms to develop a framework that will assist general practitioners In day·to-day cllnlcal work with patients presenting with concurrent multiple physical and mental health problems. DISCUSSION A positive, caring, patient centred approach is requIred and ~ultiple diagnoses need to be managed within an IntegratOd'treatment plan. The quality of the therapeutic relationship is central to patient outcomes. Assessing and managing risk issues is a priority and coordinating care with other health professionals is essential Set realistic goals, don't make changes too quickly or all at once, and don't assume , that because a patient is taking a particular medication the associated diagnosis is correct.
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