[When and how well does the family physician recognize generalized anxiety disorders and depressions?]

Recognition rates for generalized anxiety disorder (GAS) and depression in primary care and its predictors are reported.

Based on the results of GAD-P study screening questionnaires, the investigators evaluated how many patients were correctly classified by primary care physicians a) as cases with mental disorders and b) as specific disorder cases. Socio-demographic and illness history variables of patients as well as features of physicians were analyzed as predictors of recognition by regression analyzes.

Physicians recognized a mental disorder in more than two thirds of cases with GAS; rates were even higher in patients with comorbid anxiety and depression (85.4%). Recognition of the specific disorder was conspicuously worse in patients with GAS (34.4%) in comparison with patients with depression (64.3%). Only the variables of patients' demographic status and illness (e.g. higher age or, negatively, incident GAS) predicted recognition of a mental disorder.

Generalized anxiety is often recognized as a mental disorder but seldom as the specific diagnosis of GAS. This is especially true for patients without a history of mental disorders (incident cases). Suggestions for a better recognition are discussed in the light of specific psychopharmacologic and psychotherapeutic treatment demands. The risks of chronicity of this disorder as well as the ascertained predictors of good recognition are also discussed.