You Can't Treat What You Don't Diagnose: An Analysis of the Recognition of Somatic Presentations of Depression and Anxiety in Primary Care

Fam Syst Health. 2016 Dec;34(4):317-329. doi: 10.1037/fsh0000229. Epub 2016 Sep 5.

Abstract

Background: Research suggests that 13-25% of primary care patients who present with physical complaints have underlying depression or anxiety.

Objective: The goal of this paper is to quantify and compare the frequency of the diagnosis of depression and anxiety in patients with a somatic reason for visit among primary care physicians across disciplines.

Method: Data obtained from the National Ambulatory Medical Care Survey (NAMCS) from 2002 to 2010 was used to quantify primary care patients with somatic presentations who were given a diagnosis of depression or anxiety. The Patient Health Questionnaire (PHQ)-15, Somatic Symptom Scale, and the Child Behavior Checklist for Ages 6-18 were used to define what constituted a somatic reason for visit in this study.

Results: Of the patients presenting with a somatic reason for visit in this nationally representative survey, less than 4% of patents in family or internal medicine were diagnosed with depression or anxiety. Less than 1% of patients were diagnosed with depression or anxiety in pediatrics or obstetrics and gynecology. Less than 2% of patients with somatic reasons for visit in any primary care specialty had documented screening for depression.

Conclusion: The rates of diagnosis of depression and anxiety in patents presenting with somatic reasons for visit were significantly less than the prevalence reported in the literature across primary care disciplines. (PsycINFO Database Record

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / complications*
  • Anxiety / diagnosis
  • Child
  • Depression / complications*
  • Depression / diagnosis
  • Female
  • Health Care Surveys / statistics & numerical data
  • Humans
  • Male
  • Medically Unexplained Symptoms*
  • Middle Aged
  • Prevalence*
  • Primary Health Care / methods
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Surveys and Questionnaires