Use of the health history as a psychiatric screening tool.
BACKGROUND
Numerous studies indicate that most mental health services are provided in the primary care medical setting and that problems exist with misdiagnoses and lack of recognition of mental health disorders. The purpose of our investigation was to determine whether patient responses on a typical medical health history form could be used to predict depression or anxiety.


METHODS
New adult patients at a university community family practice clinic were surveyed during a 6-month period. Study patients completed a health history form and standardized inventories of anxiety and depression.


RESULTS
The study sample included 187 patients. Positive responses to mood-related symptoms reported on the health history best predicted anxiety and depression. Nonmood symptoms were also significant, although not as powerful, predictors of these disorders. A significant relation existed between total number of positive symptoms and psychiatric diagnoses, which continued when mood symptoms were removed from the analyses. Results were used to develop physical, nonmood primary care symptom profiles that could be used to screen for anxiety and depression.


CONCLUSIONS
Providing physicians the means to improve mental health diagnostics can help advance patient care and health care system outcomes.
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Department of Family Medicine, The Ohio State University, Columbus 43201, USA.
Miller
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D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005163:Factor Analysis, Statistical; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008487:Medical History Taking / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D015203:Reproducibility of Results