BACKGROUND: Videorecording of the consultation has become a widespread training and research technique in general practice. Previous studies have suggested a good level of patient acceptability. OBJECTIVE: This study aimed to elucidate patient factors associated with refusal to be videoed. METHOD: A research study of GP detection of psychological problems was carried out by opportunistic recruitment of adult attenders in primary care for collection of sociodemographic data, mental health status, and video of consultation. Patients were consented for participation in a research project by a skilled research assistant while waiting to see their general practitioner. This involved a two-stage process, where completion of a brief questionnaire was followed by consent for video before the patient entered the consulting room. RESULTS: Although the overall response rate was 85%, a surprisingly high level of refusal of consent by patients for their consultations to be videoed was found. The data were therefore analysed to examine the characteristics of the patient population, and to look for possible associated factors. The main factors associated with refusal of video consent were decreasing age, and overt presentation of a psychological problem. Although patients who were defined (either in the opinion of the GP or by mental health questionnaire score) as psychologically distressed were more likely to decline to be videoed, this was a less significant predictor of whether the patient would consent. CONCLUSIONS: Consent to be videoed may be more context-specific than previous studies have suggested. Refusal to be videoed appears to be associated with psychological problems, but the relationship is complex, and sociodemographic factors also play a part. The factors which influence consent, including the reason given for recording, need further clarification.