Screening for anxiety and depression in Primary Care: Utility of 2 brief scales adapted to the ICD-11-PC

ObjectivesThe aim of this study was to evaluate the association between integrated care and health-related quality of life (HRQOL) in a primary care practice population.DesignA cross-sectional survey study.SettingPrimary care practice population.ParticipantsA sample (n=5562) of patients in two general practitioner practices in the Netherlands.Primary outcome measuresThe Rainbow Model of Integrated Care Measurement Tool patient version and EQ-5D was used to assess integrated service delivery and HRQOL. The association between integrated care and HRQOL groups was analysed using multivariate logistic regression.ResultsOverall, 933 respondents with a mean age of 62 participated (20% response rate) in this study. The multivariate analysis revealed that positive organisational coordination experiences were linked to better HRQOL (OR=1.87, 95% CI 1.18 to 2.95), and less anxiety and depression problems (OR=0.36, 95% CI 0.20 to 0.63). Unemployment was associated with a poor HRQOL (OR=0.15, 95% CI 0.08 to 0.28). Ageing was associated with more mobility (OR=1.06, 95% CI 1.04 to 1.09), self-care (OR=1.06, 95% CI 1.02 to 1.11), usual activity (OR=1.03, 95% CI 1.01 to 1.05) and pain problems (OR=1.02, 95% CI 1.01 to 1.04). Being married improved the overall HRQOL (OR=1.60, 95% CI 1.13 to 2.26) and decreased anxiety and depression (OR=0.47, 95% CI 0.31 to 0.72). Finally, females had a poor overall HRQOL (OR=1.67, 95% CI 0.48 to 0.93) and more pain and discomfort problems (OR=1.47, 95% CI 1.11 to 1.95).ConclusionThis study shows for the first time that organisational coordination activities are positively associated with HROQL of adult patients in a primary care context, adding to the evidence of an association between integrated care and HRQOL. Also, unemployment, ageing and being female are accumulating risk factors that should be considered when designing integrated primary care programmes. Further research is needed to explore how various integration types relate to HRQOL for people in local communities.

Download Full-text

Dimensions of neuroses seen in primary-care settings

Psychological Medicine ◽

10.1017/s0033291700025022 ◽

1987 ◽

Vol 17 (2) ◽

pp. 461-470 ◽

Cited By ~ 108

Author(s):

D. P. Goldberg ◽

K. Bridges ◽

P. Duncan–Jones ◽

D. Grayson

Keyword(s):

Primary Care ◽

Psychiatric Symptoms ◽

Latent Trait ◽

Anxiety And Depression ◽

Symptom Dimensions ◽

Symptoms Of Depression ◽

Primary Care Settings ◽

Severe Manifestation ◽

The Common ◽

Highly Correlated

SynopsisThis study uses methods of latent trait analysis to examine the relationships between psychiatric symptoms that constitute the common psychiatric disorders encountered in primary-care settings. Two highly correlated symptom dimensions of anxiety and depression are shown to underlie these disorders. Neurovegetative sysmptoms of depression are shown to be on the same dimension as psychic symptoms of depression, but to represent a more severe manifestation of depression.

Download Full-text