Depressive disorders among somatizing patients in primary health care

AimTo determine the prevalence of anxiety and depressive disorders in Qatari population who attend the primary health care settings and examine their symptoms patterns and co-morbidity.DesignA cross sectional.SettingPrimary health care center, QatarSubjectsA total of 2080 Qatari subjects aged 18 to 65 years were approached and 1660 (79.8%) patients participated in this study.MethodsThe study was based on a face to face interview with a designed diagnostic screening questionnaire which consists of 17 questions about symptoms and signs of anxiety and depression disorders. Physicians determined the definitive diagnosis for depression and anxiety disorders by further checking and screening their symptoms.ResultsThe overall prevalence of depression and anxiety disorder was 13.5% and 10.3% respectively. Qatari women were at higher risk for depression (53.1% vs 46.9%) and anxiety disorder (56.7% vs 43.3%) compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 1834 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001) and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%).ConclusionThe depression was more prevalent in Qatari than anxiety disorders. The high risk groups of depression and anxiety disorders were being female, married, middle aged and highly educated.

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Epidemiological study of the prevalence of depressive disorders in primary health care in Morocco

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.169768 ◽

2015 ◽

Vol 06 (04) ◽

pp. 477-480 ◽

Cited By ~ 4

Author(s):

Bouchra Oneib ◽

Maria Sabir ◽

Naima Abda ◽

Abderazak Ouanass

Keyword(s):

Health Care ◽

Primary Health Care ◽

Depressive Disorders ◽

Univariate Analysis ◽

Dysthymic Disorder ◽

Psychiatric Disease ◽

Childbearing Age ◽

Primary Health ◽

Depressive Episodes ◽

The Impact

ABSTRACT Objective: To determine the prevalence and the impact of depressive disorders in primary health care and its associated factors. Methodology: It's a cross-sectional study with 351 participants selected from Moroccan primary care facilities, aged above 18 years without chronic somatic or psychiatric disease. The participants answered a questionnaire that included demographic characteristics, the Mini International Neuropsychiatric Interview for major depressive episode (MDE), dysthymic disorder and the Global Assessment of Functioning (GAF). Statistical analysis was performed by the SPSS 13.0 software. Results: The prevalence of depressive disorders in the sample was 13.7%, that of MDE was 9.1%, while dysthymic disorder was 4.3%, the rate of recurrent depressive episodes was 38.2% (6% of participants), and the prevalence of depression over a lifetime was 17.7%. The percentage of depression was higher among women than men (P = 0.01). 6.3% of depressed patients have already attempted to suicide. Analysis of GAF scores showed an average of 76.2 ± 24, a lower score was significantly found among patients with current MDE (P = 0.001), dysthymic subjects (P = 0.001) and those who suffer from recurrent MDE (P = 0.001). Depressive disorders in univariate analysis were associated with: Female gender P = 0.01 odds ratio (OR) 2.1 (1.09–4.3), unemployment P = 0.02 OR 0.4 (0.2–0.9), and childbearing age P = 0.004 OR 3.5 (1.5–8). Adjusted OR has not demonstrated a significant association. Conclusion: The high prevalence of depressive disorders, suicide risk, and the alteration of the quality of life among primary health care patients in Morocco suggest the importance of identifying and treating this population.

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Somatic symptom disorders and utilization of health services among Palestinian primary health care attendees: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-021-06671-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Zaher Nazzal ◽

Beesan Maraqa ◽

Marah Abu Zant ◽

Layali Qaddoumi ◽

Rana Abdallah

Keyword(s):

Health Care ◽

Primary Health Care ◽

Back Pain ◽

Chronic Diseases ◽

Somatic Symptom ◽

Depressive Disorders ◽

Common Symptom ◽

Cross Sectional ◽

Primary Health ◽

Somatic Symptom Disorders

Abstract Background Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors. Methods A cross-sectional design was used to interview 400 attendees. Men and women aged over 18 years old without a psychiatric diagnosis were invited to participate. The Somatization scale of the Four-Dimensional Symptom Questionnaire was used to assess somatic symptom disorders. It is a valid tool to be used in a PHC setting. We used the Chi-square test and multivariable logistic regression to explore determinant variables. Results Prevalence of SSD was 32.5% (95%CI = 27.9–37.1%). The most common symptoms were painful muscles (61.5%) followed by back pain (52.3%). Female gender [adjusted OR = 2.1 (95% CI = 1.2–3.7)], chronic diseases [adjusted OR = 2.4 (95%CI = 1.3–4.5)], depression [adjusted OR = 3.3 (95%CI = 2.0–5.5)], and anxiety [adjusted OR = 2.1 (95%CI = 1.2–3.6)] were all associated with SSD. In addition, frequent primary health care attendance was found to be associated with SSD [adjusted OR = 2.4 (95%CI = 1.4–4.1)]. Conclusions SSD significantly higher among females, patients with chronic diseases, clients with anxiety and depressive disorders, and patients with frequent doctors’ visits. Painful muscles and back pain are the most common symptom presented by patients, and this could be used initially by PHC physicians as a signal to consider for screening.

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Guidelines of the Polish Psychiatric Association – Wroclaw Division, the Polish Society of Family Medicine and the College of Family Physicians in Poland for diagnosis and treatment of depressive disorders in primary health care

Family Medicine & Primary Care Review ◽

10.5114/fmpcr.2017.69300 ◽

2017 ◽

Vol 3 ◽

pp. 335-346

Author(s):

Patryk Piotrowski ◽

Tomasz Maciej Gondek ◽

Joanna Rymaszewska ◽

Jan Aleksander Beszłej ◽

Sławomir Czachowski ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Medicine ◽

Depressive Disorders ◽

Family Physicians ◽

Diagnosis And Treatment ◽

Primary Health ◽

Polish Society

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Identification of somatic and anxiety symptoms which contribute to the detection of depression in primary health care

European Psychiatry ◽

10.1016/j.eurpsy.2004.04.015 ◽

2004 ◽

Vol 19 (5) ◽

pp. 250-257 ◽

Cited By ~ 23

Author(s):

Katrin Barkow ◽

Reinhard Heun ◽

T. Bedirhan Üstün ◽

Mathias Berger ◽

Isaac Bermejo ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Primary Health Care ◽

General Health ◽

Depressive Disorders ◽

Somatic Symptoms ◽

Anxiety Symptoms ◽

Primary Health ◽

The World ◽

Detection Of Depression

AbstractSomatic symptoms and anxiety symptoms are often disregarded in the detection of depression in primary care. The present investigation examined to what extent somatic and anxiety symptoms recorded with the Composite International Diagnostic Interview—Primary Health Care Version (CIDI—PHC) can improve the detection of depression as compared to the General Health Questionnaire—12-item version alone. Data from the World Health Organization study on Psychological Problems in General Health Care were used. The study sample consisted of primary care attenders from 15 centres from all over the world who underwent a psychiatric examination with the CIDI—PHC. Medically unexplained somatic symptoms (back pain, feelings of heaviness/lightness in parts of the body, periods of bodily weakness, seizures/convulsions, permanent tiredness, exhaustion after a minimum of effort) and—to a smaller extent—diverse anxiety symptoms (e.g. feelings of anxiousness/nervousness, feelings of tension, difficulties relaxing) significantly contributed to the detection of depression in a logistic regression analysis. The results confirm the observation that in primary care somatic symptoms play an important role in the manifestation of depressive disorders. The items investigated herein could prove beneficial for future depression screening instruments to improve the detection of depressive disorders in primary care.

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Validity and Applicability of the Mini International Neuropsychiatric Interview Administered by Family Resident Physicians in Primary Health Care in Brazil

European Psychiatry ◽

10.1016/s0924-9338(09)71121-6 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 1

Author(s):

J.M. Azevedo-Marques ◽

A.W. Zuardi

Keyword(s):

Health Care ◽

Primary Health Care ◽

Education Program ◽

Depressive Disorders ◽

Predictive Values ◽

Mini International Neuropsychiatric Interview ◽

Psychiatry Education ◽

Resident Physicians ◽

Primary Health ◽

Substance Abuse Disorders

Purpose:To evaluate the “Mini International Neuropsychiatric Interview (MINI)” used by family resident physicians in primary health care (PHC) in Brazil.Methods:Training for administrating the MINI was given as part of a broad psychiatry education program, and was performed in PHC consultations. Interviews were held with 120 PHC patients. MINI was administered by 25 physicians, while the “Structured Clinical Interview for Diagnosis (SCID-I)” was administered by a psychiatrist. The physicians answered questions on the applicability of the MINI.Results:Concordance levels for the following diagnoses were analyzed: any mental disorder; depressive disorders in general, major depressive episode and dysthymia; anxiety disorders in general, generalized anxiety disorder and panic disorder; and substance abuse disorders. Kappa coefficients ranged between 0.65 and 0.85; sensitivity between 0.75 and 0.92; specificity, between 0.90 and 0.99; positive predictive values (PPV) between 0.60 and 0.86; negative predictive values (NPV) between 0.92 and 0.99; and accuracy between 0.88 and 0.98. The physicians considered MINI comprehensibility and clinical relevance satisfactory; the brevity of its administration was considered satisfactory for use with previous screening only.Conclusions:These good results may be related with more frequent, intensive, and diversified training in psychiatry. The MINI is a useful tool for general practitioners and should be part of the broad psychiatry education program offered to these professionals.

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Somatic Symptom Disorders and Utilization of Health Services among Palestinian Primary Health Care Attendees: A Cross-sectional Study

10.21203/rs.3.rs-123167/v1 ◽

2020 ◽

Author(s):

Zaher Nazzal ◽

Beesan Maraqa ◽

Marah Abu Zant ◽

Layali Qaddoumi ◽

Rana Abdallah

Keyword(s):

Health Care ◽

Primary Health Care ◽

Back Pain ◽

Chronic Diseases ◽

Somatic Symptom ◽

Depressive Disorders ◽

Common Symptom ◽

Cross Sectional ◽

Primary Health ◽

Somatic Symptom Disorders

Abstract Background: Many primary health care (PHC) clients come in with medically unexplained complaints, leading to frequent consultations and high usage of services and healthcare costs. This study aimed to determine the prevalence of somatic symptom disorder (SSD) among PHC attendees and explore its relation to other mental conditions and risk factors. Methods: A cross-sectional design was used to interview 400 attendees. Men and women aged over 18 years old without a psychiatric diagnosis were invited to participate. The Somatization scale of the Four-Dimensional Symptom Questionnaire was used to assess somatic symptom disorders. It is a valid tool to be used in a PHC setting. We used the Chi-square test and multivariable logistic regression to explore determinant variables.Results: Prevalence of SSD was 32.5% (95%CI= 27.9%-37.1%). The most common symptoms were painful muscles (61.5%) followed by back pain (52.3%). Female gender [adjusted OR = 2.2 (95% CI= 1.3-4)], chronic diseases [adjusted OR = 2 (95%CI=1.1-3.6)], depression [adjusted OR = 3.2 (95%CI= 2.0-5.3)], and anxiety [adjusted OR = 3.0 (95%CI= 1.6-5.5)] were all associated with SSD. In addition, frequent primary health care attendance was found to be associated with SSD [adjusted OR = 2.2 (95%CI= 1.3-4.0)]Conclusions: SSD significantly higher among females, patients with chronic diseases, clients with anxiety and depressive disorders, and patients with frequent doctors' visits. Painful muscles and back pain are the most common symptom presented by patients, and this could be used initially by PHC physicians as a signal to consider for screening.

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Modern approaches to the diagnosis and treatment of mixed anxiety-depressive disorders in primary health care

International Professional Journal Medicine ◽

10.31082/1728-452x-2020-215-216-5-6-53-62 ◽

2021 ◽

Vol 5-6 (215-216) ◽

pp. 53-62

Author(s):

Natalya Raspopova ◽

◽

Maria Dzhamantayeva ◽

Yerbol Nurkatov ◽

Laila Uteniyazova ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Medical Practice ◽

Depressive Disorders ◽

Anxiety And Depression ◽

Outpatient Basis ◽

General Medical Practice ◽

Symptoms Of Depression ◽

Clinical Observations ◽

Primary Health

The relevance of this work is due to the wide prevalence of mixed anxiety-depressive disorders among general medical practice patients. At the present stage of development of the psychiatric service in the Republic of Kazakhstan, a new concept has been developed that assumes the transfer of a number of borderline mixed anxiety-depressive disorders to the competence of PHC doctors with the need for their treatment with modern antidepressants. The purpose of this work. Development and implementation in general clinical practice of modern methods of diagnosis and treatment of mixed anxiety-depressive disorders. Material and methods. 30 patients with mixed anxiety-depressive disorders of the borderline level, who were treated on an outpatient basis (Nursultan) was examined. The study was conducted using international psychometric scales: Hospital Anxiety and Depression Score (HADS), Hamilton Anxiety and Depression Rating Scale (HDRS, HAM-A). Results and discussion. As a result of the study, it was found that among patients with mixed anxiety-depressive disorders who were treated on an outpatient basis, young people of working age from 21 to 50 years (83.3%) prevailed, in whom psychogenic anxiety-depressive disorders accounted for 60%. In the course of clinical observations, objective data were obtained indicating that when treating depressive states of mild and moderate severity with Mianserin drug on an outpatient basis, by the end of the second week of treatment, there is a fairly pronounced positive dynamics in the reduction of symptoms of depression. By the end of the second month of taking this drug (8 weeks), most patients had no symptoms of depression. Conclusions. Practical clinical observations have shown that the modern Mianserin antidepressant, possessing a wide range of clinical effects combining thymoanaleptic action proper with anti-anxiety, sedative and hypnotic effects is well tolerated by patients and can be recommended for widespread use in the treatment of mixed anxiety-depressive disorders in general medical practice. Keywords: depression, anxiety, primary health care, general medical practice, antidepressants.

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