In a cross-sectional study of a systematic random sample of new patients attending the clinic of the G.O.P.D. of the University College Hospital, Ibadan, using the PSE, the CES-D and clinical evaluation, at least 40% of 104 subjects were found to have sufficient symptoms of psychic distress to warrant treatment. There was statistically significant association between the measures for psychiatric caseness. Among those rated as psychiatric cases on clinical evaluation, neurosis was the predominant diagnosis. Symptoms of depression were commonly admitted to by these subjects. At review of case notes one year later, the initial diagnoses for those referred to the psychiatric clinic were sustained. In view of the commoness of psychiatric symptoms in general practice, it is suggested that undergraduate psychiatric posting duration be increased; residency training in general practice and internal medicine should include a period of posting in psychiatry; and national health care planning should pay a greater attention to mental health care than is at present the case.