title: The role of somatic health problems in the recognition of depressive and anxiety disorders by general practitioners.
abstract: BACKGROUND
  Recognition of depression and anxiety by general practitioners (GPs) is suboptimal and there is uncertainty as to whether particular somatic health problems hinder or facilitate GP recognition. The objective of this study was to investigate the associations between somatic health problems and GP recognition of depression and anxiety.
  
  
  METHODS
  We studied primary care patients with a DSM-IV based psychiatric diagnosis of depressive or anxiety disorder during a face-to-face interview (n=778). GPs' registrations of depression and anxiety diagnoses, based on medical file extractions, were compared with the DSM-IV based psychiatric diagnoses as reference standard. Somatic health problems were based on self-report of several chronic somatic diseases and pain symptoms, using the Chronic Pain Grade (CPG), during the interview.
  
  
  RESULTS
  Depression and anxiety was recognized in sixty percent of the patients. None of the health problems were negatively associated with recognition. Greater severity of pain symptoms (OR=1.18, p=.02), and chest pain (OR=1.56, p=.02), in particular, were associated with more GP recognition of depression and anxiety. Mediation analyses showed that depression and anxiety in these patients were better recognized through the presence of more severe psychiatric symptoms.
  
  
  CONCLUSIONS
  Some specific chronic diseases had low prevalence.
  
  
  CONCLUSIONS
  This study shows that the presence of particular chronic diseases does not influence GP recognition of depression and anxiety. GPs tend to recognize depression and anxiety better in patients with pain symptoms, partly due to more severe psychiatric symptoms among those with pain.
authors.affiliation: Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. Electronic address: mj.gerrits@vumc.nl.
authors.forename: Marloes M J G
authors.initials: MM
authors.lastname: Gerrits
authors.forename: Harm W J
authors.initials: HW
authors.lastname: van Marwijk
authors.forename: Patricia
authors.initials: P
authors.lastname: van Oppen
authors.forename: Henriette
authors.initials: H
authors.lastname: van der Horst
authors.forename: Brenda W J H
authors.initials: BW
authors.lastname: Penninx
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis*; D002908:Chronic Disease / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D010146:Pain / Q000523:psychology
keywords: Anxiety disorder; Depressive disorder; General practitioner; Recognition; Somatic health