The role of somatic health problems in the recognition of depressive and anxiety disorders by general practitioners

Marloes M. J. G. Gerrits*, Harm W. J. van Marwijk, Patricia van Oppen, Henriette van der Horst, Brenda W. J. H. Penninx

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    10 Citations (Scopus)

    Abstract

    Background: Recognition of depression and anxiety by general practitioners (GPs) is suboptimal and there is uncertainty as to whether particular somatic health problems hinder or facilitate GP recognition. The objective of this study was to investigate the associations between somatic health problems and GP recognition of depression and anxiety.

    Methods: We studied primary care patients with a DSM-IV based psychiatric diagnosis of depressive or anxiety disorder during a face-to-face interview (n=778). GPs registrations of depression and anxiety diagnoses, based on medical file extractions, were compared with the DSM-IV based psychiatric diagnoses as reference standard. Somatic health problems were based on self-report of several chronic somatic diseases and pain symptoms, using the Chronic Pain Grade (CPG), during the interview.

    Results: Depression and anxiety was recognized in sixty percent of the patients. None of the health problems were negatively associated with recognition. Greater severity of pain symptoms (OR 118, p=.02), and chest pain (OR=1.56, p=.02), in particular, were associated with more GP recognition of depression and anxiety. Mediation analyses showed that depression and anxiety in these patients were better recognized through the presence of more severe psychiatric symptoms.

    Limitations: Some specific chronic diseases had low prevalence.

    Conclusions: This study shows that the presence of particular chronic diseases does not influence GP recognition of depression and anxiety. GPs tend to recognize depression and anxiety better in patients with pain symptoms, partly due to more severe psychiatric symptoms among those with pain. (C) 2013 Elsevier B.V. All rights reserved

    Original languageEnglish
    Pages (from-to)1025-1032
    Number of pages8
    JournalJournal of Affective Disorders
    Volume151
    Issue number3
    DOIs
    Publication statusPublished - Dec-2013

    Keywords

    • Depressive disorder
    • Anxiety disorder
    • Recognition
    • General practitioner
    • Somatic health
    • K10 SCREENING SCALES
    • PRIMARY-CARE
    • MAJOR DEPRESSION
    • MENTAL-HEALTH
    • UNRECOGNIZED DEPRESSION
    • PSYCHOMETRIC PROPERTIES
    • CASE EXTRACTION
    • PAIN
    • NETHERLANDS
    • VALIDITY

    Cite this