title: [Concordance in diagnosis between primary care and mental health].
abstract: 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.
authors.affiliation: Centro de Salud Mental de Estella. Navarra. España. natalia.landa.gonzalez@cfnavarra.es
authors.forename: Natalia
authors.initials: N
authors.lastname: Landa González
authors.forename: Adriana
authors.initials: A
authors.lastname: Goñi Sarriés
authors.forename: Elena
authors.initials: E
authors.lastname: García de Jalón Aramayo
authors.forename: Eva
authors.initials: E
authors.lastname: Lizasoain Urra
mesh_terms: 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