TY - JOUR
KW - Adult
KW - Age Factors
KW - Anxiety Disorders/classification/diagnosis/epidemiology/psychology
KW - Comorbidity
KW - Cross-Sectional Studies
KW - Curriculum
KW - Depressive Disorder/classification/diagnosis/epidemiology/psychology
KW - Diagnosis, Differential
KW - Diagnostic and Statistical Manual of Mental Disorders
KW - Education, Medical, Continuing
KW - Family Practice/education
KW - Female
KW - Humans
KW - International Classification of Diseases
KW - Male
KW - Middle Aged
KW - Personality Inventory/statistics & numerical data
KW - Practice Guidelines as Topic
KW - Primary Health Care
KW - Psychometrics
KW - Sex Factors
KW - Socioeconomic Factors
KW - Somatoform Disorders/classification/diagnosis/epidemiology/psychology
AU - G. Hanel
AU - P. Henningsen
AU - W. Herzog
AU - N. Sauer
AU - R. Schaefert
AU - J. Szecsenyi
AU - B. Lowe
A1 - 
AB - OBJECTIVE: Depression, anxiety, and somatization are the most frequently observed mental disorders in primary health care. Our main objective was to draw on the often neglected general practitioners' (GPs) perspective to investigate what characterizes these three common mental diagnoses with regard to creating more suitable categories in the DSM-V and ICD-11. METHODS: We collected independent data from 1751 primary care patients (participation rate=77%) and their 32 treating GPs in Germany. Patients filled out validated patient self-report measures for depression (PHQ-9), somatic symptom severity (PHQ-15), and illness anxiety (Whiteley-7), and questions regarding coping and attribution of illness. GPs' clinical diagnoses and associated features were assessed. RESULTS: Patients diagnosed by their GPs with depression, anxiety, and/or somatoform disorders were significantly older, less educated, and more often female than the reference group not diagnosed with a mental disorder. They had visited the GP more often, had a longer duration of symptoms, and were more often under social or financial stress. Among the mental disorders diagnosed by the GPs, depression (OR=4.4; 95% CI=2.6 to 7.5) and comorbidity of somatoform, depressive, and anxiety disorders (OR=9.5; 95% CI=4.6 to 19.4) were associated with the largest degrees of impairment compared to the reference group. Patients diagnosed as having a somatoform/functional disorder only had mildly elevated impairment on all dimensions (OR=2.0; 95% CI=1.4 to 2.7). Similar results were found for the physicians' attribution of psychosocial factors for cause and maintenance of the disease, difficult patient-doctor relationship, and self-assessed mental disorder. CONCLUSION: In order to make the DSM-V and ICD-11 more suitable for primary care, we propose providing appropriate diagnostic categories for (1) the many mild forms of mental syndromes typically seen in primary care; and (2) the severe forms of comorbidity between somatoform, depressive, and/or anxiety disorder, e.g., with a dimensional approach.
BT - Journal of psychosomatic research
C5 - Medically Unexplained Symptoms
CP - 3
CY - England
DO - 10.1016/j.jpsychores.2009.04.013
IS - 3
JF - Journal of psychosomatic research
N2 - OBJECTIVE: Depression, anxiety, and somatization are the most frequently observed mental disorders in primary health care. Our main objective was to draw on the often neglected general practitioners' (GPs) perspective to investigate what characterizes these three common mental diagnoses with regard to creating more suitable categories in the DSM-V and ICD-11. METHODS: We collected independent data from 1751 primary care patients (participation rate=77%) and their 32 treating GPs in Germany. Patients filled out validated patient self-report measures for depression (PHQ-9), somatic symptom severity (PHQ-15), and illness anxiety (Whiteley-7), and questions regarding coping and attribution of illness. GPs' clinical diagnoses and associated features were assessed. RESULTS: Patients diagnosed by their GPs with depression, anxiety, and/or somatoform disorders were significantly older, less educated, and more often female than the reference group not diagnosed with a mental disorder. They had visited the GP more often, had a longer duration of symptoms, and were more often under social or financial stress. Among the mental disorders diagnosed by the GPs, depression (OR=4.4; 95% CI=2.6 to 7.5) and comorbidity of somatoform, depressive, and anxiety disorders (OR=9.5; 95% CI=4.6 to 19.4) were associated with the largest degrees of impairment compared to the reference group. Patients diagnosed as having a somatoform/functional disorder only had mildly elevated impairment on all dimensions (OR=2.0; 95% CI=1.4 to 2.7). Similar results were found for the physicians' attribution of psychosocial factors for cause and maintenance of the disease, difficult patient-doctor relationship, and self-assessed mental disorder. CONCLUSION: In order to make the DSM-V and ICD-11 more suitable for primary care, we propose providing appropriate diagnostic categories for (1) the many mild forms of mental syndromes typically seen in primary care; and (2) the severe forms of comorbidity between somatoform, depressive, and/or anxiety disorder, e.g., with a dimensional approach.
PP - England
PY - 2009
SN - 1879-1360; 0022-3999
SP - 189
EP - 197
EP - 
T1 - Depression, anxiety, and somatoform disorders: vague or distinct categories in primary care? Results from a large cross-sectional study
T2 - Journal of psychosomatic research
TI - Depression, anxiety, and somatoform disorders: vague or distinct categories in primary care? Results from a large cross-sectional study
U1 - Medically Unexplained Symptoms
U2 - 19686874
U3 - 10.1016/j.jpsychores.2009.04.013
VL - 67
VO - 1879-1360; 0022-3999
Y1 - 2009
ER -