Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care.
Somatic symptoms and anxiety symptoms are often disregarded in the detection of depression in primary care. The present investigation examined to what extent somatic and anxiety symptoms recorded with the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC) can improve the detection of depression as compared to the General Health Questionnaire-12-item version alone. Data from the World Health Organization study on Psychological Problems in General Health Care were used. The study sample consisted of primary care attenders from 15 centres from all over the world who underwent a psychiatric examination with the CIDI-PHC. Medically unexplained somatic symptoms (back pain, feelings of heaviness/lightness in parts of the body, periods of bodily weakness, seizures/convulsions, permanent tiredness, exhaustion after a minimum of effort) and-to a smaller extent-diverse anxiety symptoms (e.g. feelings of anxiousness/nervousness, feelings of tension, difficulties relaxing) significantly contributed to the detection of depression in a logistic regression analysis. The results confirm the observation that in primary care somatic symptoms play an important role in the manifestation of depressive disorders. The items investigated herein could prove beneficial for future depression screening instruments to improve the detection of depressive disorders in primary care.
Department of Psychiatry, University of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. katrin.barkow@ukb.uni-bonn.de
Katrin
K
Barkow
Reinhard
R
Heun
T Bedirhan
TB
Ustün
Mathias
M
Berger
Isaac
I
Bermejo
Wolfgang
W
Gaebel
Martin
M
Härter
Frank
F
Schneider
Rolf-Dieter
RD
Stieglitz
Wolfgang
W
Maier
D001008:Anxiety Disorders / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D011320:Primary Health Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014944:World Health Organization