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

Henny Sinnema, Berend Terluin, Daniëlle Volker, Michel Wensing, Anton Van Balkom

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Article number99
JournalBMC Family Practice
Volume19
Issue number1
DOIs
Publication statusPublished - 23 Jun 2018

Cite this

@article{200aedcbea0649bb8895a5300dc2b53c,
title = "Factors contributing to the recognition of anxiety and depression in general practice",
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",
author = "Henny Sinnema and Berend Terluin and Dani{\"e}lle Volker and Michel Wensing and {Van Balkom}, Anton",
year = "2018",
month = "6",
day = "23",
doi = "10.1186/s12875-018-0784-8",
language = "English",
volume = "19",
journal = "BMC Family Practice",
issn = "1471-2296",
publisher = "BioMed Central",
number = "1",

}

Factors contributing to the recognition of anxiety and depression in general practice. / Sinnema, Henny; Terluin, Berend; Volker, Daniëlle; Wensing, Michel; Van Balkom, Anton.

In: BMC Family Practice, Vol. 19, No. 1, 99, 23.06.2018.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Factors contributing to the recognition of anxiety and depression in general practice

AU - Sinnema, Henny

AU - Terluin, Berend

AU - Volker, Daniëlle

AU - Wensing, Michel

AU - Van Balkom, Anton

PY - 2018/6/23

Y1 - 2018/6/23

N2 - 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.

AB - 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.

KW - Anxiety

KW - Depression

KW - General practitioner

KW - Primary care

KW - Recognition

UR - http://www.scopus.com/inward/record.url?scp=85048950865&partnerID=8YFLogxK

U2 - 10.1186/s12875-018-0784-8

DO - 10.1186/s12875-018-0784-8

M3 - Article

VL - 19

JO - BMC Family Practice

JF - BMC Family Practice

SN - 1471-2296

IS - 1

M1 - 99

ER -