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Psychiatric diagnosis in primary care patients with increased depressive symptoms |
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| Authors: | Satu Kotiaho Katariina Korniloff Mauno Vanhala Hannu Kautiainen Hannu Koponen Tiina Ahonen |
| Institution: | 1. School of Medicine, General Practice, University of Eastern Finland, Kuopio, Finland;2. Saarikka Primary Health Care Public Utility, Saarij?rvi, Finland;3. School of Health and Social Studies, JAMK University of Applied Sciences, Jyv?skyl?, Finland;4. Faculty of Sport and Health Sciences, University of Jyv?skyl?, Jyv?skyl?, Finland;5. Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland;6. Folkh?lsan Research Center, Helsinki, Finland;7. Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland |
| Abstract: | Background: Screening of depression has been recommended in primary care and Beck’s 21-item Depression Inventory (BDI-21) is a commonly used tool for screening. Depression has been shown to be frequently accompanied by comorbidities. Aims: This study aimed to analyze the characteristics, psychiatric diagnoses, and psychiatric comorbidity of primary care patients who have been screened for depression and referred to a depression nurse. Methods: The study subjects were primary care patients aged ≥ 35 years with depressive symptoms (BDI-21?>?9). Their psychiatric diagnosis were based on a diagnostic interview (Mini-International Neuropsychiatric Interview; M.I.N.I.) conducted by a trained study nurse. Results: Of the 705 study subjects, 617 (87.5%) had at least one and 66.1% had at least two psychiatric diagnoses. The most common diagnosis was depression (63.4%). The next most common diagnoses were generalized anxiety disorder (GAD) (48.1%) and panic disorder (22.8%). Only 8.8% of the study subjects had depression without other psychiatric disorders. Ten percent of the subjects had both depression and a generalized anxiety disorder (GAD). Also other psychiatric comorbidities were common. Age was inversely associated with the psychiatric diagnosis in the M.I.N.I. Conclusions: This study suggests that most of the primary care patients with increased depressive symptoms have a psychiatric disorder. Although depression is the most common diagnosis, there are several other concurrent psychiatric comorbidities. Therefore, diagnostic assessment of primary care patients with a screening score over 9 in the BDI-21 should be reconsidered. |
| Keywords: | Primary care Beck’s 21-item Depression Inventory screening depression |