title: Utilizing a medical questionnaire to predict anxiety and depression in outpatients.
abstract: BACKGROUND
  Anxiety and depressive symptoms are seen in patients with anxiety and mood disorders but are also common in those with organic disorders. However, since physical symptoms are predominant complaints from patients who visit nonpsychiatric outpatient clinics, anxiety and depressive symptoms are often unrecognized. It is important for physicians to be aware of these issues concurrent with the physical symptoms. We therefore examined whether a self-administered medical questionnaire could identify anxiety and depressive symptoms.
  
  
  METHODS
  A total of 453 patients on their first visit to the Department of General Medicine, Chiba University Hospital, Chiba, Japan, participated in this study. They were asked to complete a medical questionnaire and the Hospital Anxiety and Depression Scale questionnaire before examination. Data on age, sex, number of complaints, symptom duration, and number of previous physicians were extracted from the medical questionnaire. These data were used as independent variables in logistic regression analysis to develop a predictive model for the presence of anxiety and depressive symptoms.
  
  
  RESULTS
  Data from 358 (79.0%) patients were included in the analyses. Logistic regression analysis identified the following predictors: "three or more complaints" (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.48-3.88) and "four or more previous physicians" (OR 1.72; 95% CI 1.10-2.69). In the predictive model for the presence of symptoms of anxiety and depression, the likelihood ratio was 2.40 (95% CI 1.33-4.34) in patients reporting both conditions and 1.35 (95% CI 1.04-1.77) in those reporting either condition.
  
  
  CONCLUSIONS
  The presence of anxiety and depressive symptoms can be predicted from the items of a medical questionnaire in outpatients visiting a general medicine department of a university hospital. When patients report three or more complaints or four or more previous physicians on a medical questionnaire, physicians should consider the presence of anxiety or depression or both in differential diagnosis.
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kajiwara
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ohira
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Ikegami
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Hanazawa
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan; Department of General Medicine, Kimitsu Chuo Hospital, Kisarazu-shi, Chiba, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Masuyama
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Shikino
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba-shi, Japan.
authors.forename: Masatomi
authors.initials: M
authors.lastname: Ikusaka
keywords: HADS; Hospital Anxiety and Depression Scale; anxiety; complaint numbers; depression; medical questionnaire; number of previous physicians