[Concordance in diagnosis between primary care and mental health].
OBJECTIVE
To analyse the diagnostic concordance index between primary care and mental health.


METHODS
Retrospective and descriptive study.


METHODS
Mental health centre, Estella, Navarra, Spain. PARTICIPANTS. New consecutive adults patients referred to mental health (n=1005) from july 2002 to march 2005.


METHODS
Analysis of diagnoses made in primary care and mental health during the time period. Calculation of kappa index for inter-observer concordance.


RESULTS
General diagnostic concordance had a kappa index =0.385 (+/-0.018). High concordance index (>0.7) was obtained for alcohol and other substance use disorders and psychotic disorders. Moderate concordance index (0.4-0.7) was obtained for eating disorders and organic mental disorders. However, low concordance index (<0.3) was obtained for anxiety, adaptative, and affective disorders.


CONCLUSIONS
In general, diagnostic concordance between primary care and mental health is weak. Particularly noticeable was difficulty in identifying adaptative disorders adequately. There was a strong tendency in primary care to identify these disorders as anxiety or affective disorders.
Landa González
Natalia
N
Centro de Salud Mental de Estella. Navarra. España. natalia.landa.gonzalez@cfnavarra.es
Goñi Sarriés
Adriana
A
García de Jalón Aramayo
Elena
E
Lizasoain Urra
Eva
E
D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D011320:Primary Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies