Recognition of anxiety disorders by the general practitioner: results from the DASMAP Study
Recognition of anxiety disorders by the general practitioner: results from the DASMAP Study
复制标题
DOI：
10.1016/j.genhosppsych.2012.01.012
复制
发表时间：
2012-05-01
影响因子：
7
通讯作者：
Serrano-Blanco, Antoni
中科院分区：
文献类型：
--
作者：
Fernandez, Anna;Rubio-Valera, Maria;Serrano-Blanco, Antoni
目的：目的是确定全科医生 (GP) 对焦虑症的认识水平并检查相关因素。方法：在加泰罗尼亚代表的 77 个初级保健中心进行了流行病学调查。总共对 3815 名患者进行了评估。结果：在 666 名患者中，全科医生确定了 185 名患者符合 DSM-IV 轴 1 疾病结构化临床访谈 (SCID-1) 中任何焦虑症的标准（敏感性 0.28）。关于特定的焦虑症，只有三名患者出现惊恐障碍，根据 SCID-I，他们不符合这种情况的标准。全科医生记录了 46 例广泛性焦虑障碍，其中 4 例符合 SCID-I（敏感性 0.03）。合并高血压的存在与识别概率的增加相关。情绪问题作为患者的主要主诉以及心理健康专家的额外预约与充分和错误的认识有关。作为女性，更频繁地看全科医生以及更高水平的自我感知压力都与误报有关。随着残疾的增加，被错误检测的可能性降低。结论：全科医生识别出一些患者的焦虑症，但在区分焦虑症亚型和残疾评估方面仍然失败。 (C) 2012 Elsevier Inc. 保留所有权利。
Objectives: The objectives were to determine the levels of general practitioner (GP) recognition of anxiety disorders and examine associated factors.Methods: An epidemiological survey was carried out in 77 primary care centers representative of Catalonia. A total of 3815 patients were assessed.Results: GPs identified 185 of the 666 individuals diagnosed as meeting the Structured Clinical Interview for DSM-IV Axis 1 Disorders (SCID-1) criteria for any anxiety disorder (sensitivity 0.28). Regarding specific anxiety disorders, panic disorder was registered in just three of the patients who, according to the SCID-I, did not meet the criteria for this condition. Generalized anxiety disorder was recorded by the GP in 46 cases, 4 of them being concordant with the SCID-I (sensitivity 0.03). The presence of comorbid hypertension was associated with an increased probability of recognition. Emotional problems as the patients' main complaint and additional appointments with a mental health specialist were associated with both adequate and erroneous recognition. Being female, having more frequent appointments with the GP and having higher levels of self-perceived stress were related to false positives. As disability increased, the probability of being erroneously detected decreased.Conclusion: GPs recognized anxiety disorders in some sufferers but still failed with respect to differentiating between anxiety disorder subtypes and disability assessment. (C) 2012 Elsevier Inc. All rights reserved.