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[Physician's perception of mental malaise in a basic health district]
P Barreto Ramón1, M E Corral Mata, J Muñoz López
1ABS Les Planes, Sant Joan Despí, Barcelona.
Objectives:
a) To determine the prevalence of psychological malaise (PM) in the population-group attending. b) To find the sensitivity and specificity of diagnoses of anxiety-depression made by doctors and on the Goldberg Anxiety and Depression Scale (GADS), using the Mini International Neuropsychiatric Interview (MINI) as gold standard. c) To study whether there are factors that might affect PM's detection.
Design:
Crossover study.
Setting:
Urban health centre.
Participants:
252 patients from the general population between 15 and 65 who attended for consultation for 10 days in May 1997.
Measurements And Results:
The clinical diagnosis of 1266 patients was recorded. A sample was selected at random, to whom both the GADS and the MINI were administered, so as to compare the diagnoses. The prevalence of PM according to clinical judgement was similar to that found with the MINI (40.9%), with a clear overdiagnosis on the GADS. Clinical judgement mainly detected the anxiety component. The results of clinical judgement and the GADS were compared with the MINI (gold standard), and sensitivity of 73.78% and specificity of 72.48% were found for clinical judgement, and sensitivity of 95% and specificity of 64.4% for the GADS.
Conclusions:
Prevalence of PM is high. The GADS showed it was useful for PM screening. The doctor's ability to detect PM is considerable. We found no variables that might affect diagnostic error.