title: Recognition of depressive and anxiety disorders in dermatological outpatients.
abstract: Although mental disorders are frequent among dermatological patients, little is known about their recognition by dermatologists. This study aimed to assess dermatologists' ability to recognize depressive and anxiety disorders. All adult outpatients who visited four dermatologists on predetermined days (n=317) completed the 12-item General Health Questionnaire (GHQ-12) and the section on depressive and anxiety disorders of the Patient Health Questionnaire (PHQ). Dermatologists, masked to GHQ-12 and PHQ scores, rated patients' mental health status. The analysis was performed on 277 patients (87%) with complete data. With the PHQ as criterion standard, the dermatologists' assessment sensitivity was 33%, while specificity was 76%. In most cases of disagreement between the dermatologists and the PHQ, the GHQ-12 corroborated the PHQ classification. Anxiety disorders tended to be recognized better than depressive disorders. Among patients with a PHQ diagnosis, male gender tended to be associated with misclassification by dermatologists. Although limitations inherent in self-report psychiatric assessment should be considered, this study suggests that mental disorders often go unrecognized in dermatological patients. This issue might be addressed by implementing specific training programmes, using validated screening questionnaires for depression and anxiety, and developing rational consultation-liaison services.
authors.affiliation: Dermatological Institut IDI-IRCCS, Rowe, Italy. a.picardi@idi.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
authors.forename: Paolo
authors.initials: P
authors.lastname: Amerio
authors.forename: Giannandrea
authors.initials: G
authors.lastname: Baliva
authors.forename: Claudio
authors.initials: C
authors.lastname: Barbieri
authors.forename: Patrizia
authors.initials: P
authors.lastname: Teofoli
authors.forename: Simone
authors.initials: S
authors.lastname: Bolli
authors.forename: Valentina
authors.initials: V
authors.lastname: Salvatori
authors.forename: Eva
authors.initials: E
authors.lastname: Mazzotti
authors.forename: Paolo
authors.initials: P
authors.lastname: Pasquini
authors.forename: Damiano
authors.initials: D
authors.lastname: Abeni
mesh_terms: D000328:Adult; D000367:Age Factors; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D002983:Clinical Competence; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology; D010818:Practice Patterns, Physicians'; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D012871:Skin Diseases / Q000523:psychology*; D011795:Surveys and Questionnaires