Diagnosis of somatoform disorders in primary care: diagnostic agreement, predictors, and comaprisons with depression and anxiety
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Diagnosis of somatoform disorders in primary care: diagnostic agreement, predictors, and comaprisons with depression and anxiety. / Piontek, Katharina; Shedden-Mora, Meike C; Gladigau, Maria; Kuby, Amina; Löwe, Bernd.
In: BMC PSYCHIATRY, Vol. 18, No. 1, 12.11.2018, p. 361.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Diagnosis of somatoform disorders in primary care: diagnostic agreement, predictors, and comaprisons with depression and anxiety
AU - Piontek, Katharina
AU - Shedden-Mora, Meike C
AU - Gladigau, Maria
AU - Kuby, Amina
AU - Löwe, Bernd
PY - 2018/11/12
Y1 - 2018/11/12
N2 - BACKGROUND: To investigate (a) the diagnostic agreement between diagnoses of somatoform disorders, depressive and anxiety disorders obtained from a structured clinical interview and diagnoses reported from primary care physicians (PCPs) and (b) to identify patient and PCP-related predictors for the diagnostic agreement regarding the presence of a somatoform disorder.METHODS: Data from a cross-sectional study comprising 112 primary care patients at high risk for somatoform disorders were analyzed. Diagnoses according to International Classification of Diseases, 10th revision (ICD-10) for somatoform, depressive and anxiety disorders were obtained from the Composite International Diagnostic Interview (CIDI) and compared with the diagnoses of the patients' PCPs documented in their medical records. Using multiple regression analyses, predictors for the PCPs' diagnosis of a somatoform disorder were analyzed.RESULTS: The agreement between PCP diagnoses and CIDI diagnoses was 32.3% for somatoform disorders, 48.0% for depressive disorders and 25.0% for anxiety disorders. Multiple regression analyses revealed the likelihood of being diagnosed with a somatoform disorder by PCP increased with somatic symptom severity (OR = 1.22, 95% CI 1.03-1.44). Regarding PCP-related characteristics, a specialization in internal medicine (OR = 5.95, 95% CI 1.70-20.80) and working in a solo practice (OR = 2.92, 95% CI 1.02-8.38) increased the likelihood that patients were diagnosed with a somatoform disorder.CONCLUSIONS: The present results indicate that the process of diagnosing somatoform disorders in primary care needs to be improved. Findings further underline the necessity to implement appropriate strategies to improve early detection of patients.TRIAL REGISTRATION: ISRCTN ISRCTN55870770 . Registered 22 October 2014. Retrospectively registered.
AB - BACKGROUND: To investigate (a) the diagnostic agreement between diagnoses of somatoform disorders, depressive and anxiety disorders obtained from a structured clinical interview and diagnoses reported from primary care physicians (PCPs) and (b) to identify patient and PCP-related predictors for the diagnostic agreement regarding the presence of a somatoform disorder.METHODS: Data from a cross-sectional study comprising 112 primary care patients at high risk for somatoform disorders were analyzed. Diagnoses according to International Classification of Diseases, 10th revision (ICD-10) for somatoform, depressive and anxiety disorders were obtained from the Composite International Diagnostic Interview (CIDI) and compared with the diagnoses of the patients' PCPs documented in their medical records. Using multiple regression analyses, predictors for the PCPs' diagnosis of a somatoform disorder were analyzed.RESULTS: The agreement between PCP diagnoses and CIDI diagnoses was 32.3% for somatoform disorders, 48.0% for depressive disorders and 25.0% for anxiety disorders. Multiple regression analyses revealed the likelihood of being diagnosed with a somatoform disorder by PCP increased with somatic symptom severity (OR = 1.22, 95% CI 1.03-1.44). Regarding PCP-related characteristics, a specialization in internal medicine (OR = 5.95, 95% CI 1.70-20.80) and working in a solo practice (OR = 2.92, 95% CI 1.02-8.38) increased the likelihood that patients were diagnosed with a somatoform disorder.CONCLUSIONS: The present results indicate that the process of diagnosing somatoform disorders in primary care needs to be improved. Findings further underline the necessity to implement appropriate strategies to improve early detection of patients.TRIAL REGISTRATION: ISRCTN ISRCTN55870770 . Registered 22 October 2014. Retrospectively registered.
KW - Journal Article
U2 - 10.1186/s12888-018-1940-3
DO - 10.1186/s12888-018-1940-3
M3 - SCORING: Journal article
C2 - 30419878
VL - 18
SP - 361
JO - BMC PSYCHIATRY
JF - BMC PSYCHIATRY
SN - 1471-244X
IS - 1
ER -