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. 2018 Jun 23;19(1):99.
doi: 10.1186/s12875-018-0784-8.

Factors contributing to the recognition of anxiety and depression in general practice

Henny Sinnema  1 , Berend Terluin  2 , Daniëlle Volker  3 , Michel Wensing  4 , Anton van Balkom  5
Affiliations

Factors contributing to the recognition of anxiety and depression in general practice

Henny Sinnema et al. BMC Fam Pract. .

Abstract

Background: Adequate recognition of anxiety and depression by general practitioners (GPs) can be improved. Research on factors that are associated with recognition is limited and shows mixed results. The aim of this study was to explore which patient and GP characteristics are associated with recognition of anxiety and depression.

Methods: We performed a secondary analysis on data from 444 patients who were recruited for a randomized trial. Recognition of anxiety and depression was defined in terms of information in the medical records, in patients who screened positive on the extended Kessler 10 (EK-10). A total of 10 patient and GP characteristics, measured at baseline, were tested and included in a multilevel regression model to examine their impact on recognition.

Results: Patients who reported a perceived need for psychological care (OR = 2.54, 95% CI 1.60-4.03) and those with higher 4DSQ distress scores (OR = 1.03; 95% CI 1.00-1.07) were more likely to be recognized. In addition, patients' anxiety or depression was less likely to be recognized when GPs were less confident in their abilities to identify depression (OR = 0.97; 95% CI 0.95-0.99). Patients' age, chronic medical condition, somatisation, severity of anxiety and depression, and functional status were not associated with the recognition of anxiety and depression.

Conclusions: There is room for improvement of the recognition of anxiety and depression. Quality improvement activities that focus on increasing GPs' confidence in the ability to identify symptoms of distress, anxiety and depression, as part of care according to guidelines, may improve recognition.

Keywords: Anxiety; Depression; General practitioner; Primary care; Recognition.

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Conflict of interest statement

Ethics approval and consent to participate

This is a secondary analysis and consent and approval was previously obtained from the Medical Ethics Committee of the Institutions for Mental Health (METiGG; Utrecht, The Netherlands, number NL28350.097.09), and participants gave informed consent.

Competing interests

H Sinnema: None declared.

B Terluin: is the copyright owner of the 4DSQ and receives copyright fees from companies that use the 4DSQ on a commercial basis (the 4DSQ is freely available for non-commercial use in health care and research). BT received fees from various institutions for workshops on the application of the 4DSQ in primary care settings.

D Volker: None declared.

M Wensing: None declared.

A van Balkom: None declared.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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