A Trial Integrating Different Methods to Assess Psychosocial Problems in Primary Care

Area of Science:

• Psychiatry
• Primary Care Medicine
• Psychosomatic Research

Background:

• Primary care patients frequently experience psychosocial problems, psychiatric conditions, and reduced quality of life.
• These issues can be challenging to identify and manage within a general medical setting.

Purpose of the Study:

• To evaluate the combined utility of diagnostic interviews and self-rated questionnaires in primary care.
• To assess the prevalence of DSM-5 and Diagnostic Criteria for Psychosomatic Research (DCPR) diagnoses in primary care.

Main Methods:

• Two hundred primary care patients in Italy were assessed.
• Utilized the Structured Clinical Interview for DSM-5 (SCID-5) and the revised Semi-Structured Interview for the Diagnostic Criteria for Psychosomatic Research (DCPR).
• Administered self-rated questionnaires: PsychoSocial Index, Short-Form Health Survey, and Illness Attitude Scales.

Main Results:

• 46 patients (23%) met DSM-5 criteria; 88 patients (44%) met DCPR criteria (maladaptive illness behavior, allostatic overload, demoralization).
• A significant number of patients (23.5%) had DCPR diagnoses only, highlighting unmet needs.
• Patients with DCPR diagnoses reported higher distress and lower quality of life.

Conclusions:

• Self-rated tools like the PsychoSocial Index can quickly identify patient distress in busy primary care settings.
• The DCPR identifies psychosocial problems not captured by DSM-5, aiding assessment and treatment planning.
• Integrating DCPR can enhance the management of psychosomatic issues by primary care psychologists and psychiatrists.