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[Concordance in diagnosis between primary care and mental health]
Natalia Landa González1, Adriana Goñi Sarriés, Elena García de Jalón Aramayo
1Centro de Salud Mental de Estella. Navarra. España. natalia.landa.gonzalez@cfnavarra.es
Objective:
To analyse the diagnostic concordance index between primary care and mental health.
Design:
Retrospective and descriptive study.
Setting:
Mental health centre, Estella, Navarra, Spain. PARTICIPANTS. New consecutive adults patients referred to mental health (n=1005) from july 2002 to march 2005.
Main Measurements:
Analysis of diagnoses made in primary care and mental health during the time period. Calculation of kappa index for inter-observer concordance.
Results:
General diagnostic concordance had a kappa index =0.385 (+/-0.018). High concordance index (>0.7) was obtained for alcohol and other substance use disorders and psychotic disorders. Moderate concordance index (0.4-0.7) was obtained for eating disorders and organic mental disorders. However, low concordance index (<0.3) was obtained for anxiety, adaptative, and affective disorders.
Conclusions:
In general, diagnostic concordance between primary care and mental health is weak. Particularly noticeable was difficulty in identifying adaptative disorders adequately. There was a strong tendency in primary care to identify these disorders as anxiety or affective disorders.
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