Recognition of depression and anxiety in primary care

BMJ 1999;319:254 ( 24 July )

Letters

Recognition of depression and anxiety in primary care

General practitioners in study seemed to agree with commentary writer

Authors' reply

General practitioners in study seemed to agree with commentary writer

The first 150 words of the full text of this article appear below.

EDITOR $---$ Kessler et al assessed the ability of general practitioners to diagnose depression and anxiety as defined by the generalhealth questionnaire (GHQ-12).¹ Unfortunately, they have miscalculatedtheir results; from their data, the general practitioners hada sensitivity of 36% and a specificity of 91%.

These figures suggest that the participating general practitioners $---$ at least in their day to day practice $---$ shared Heath's opinionin her commentary.¹ Most patients with a score >3 on the generalhealth questionnaire do not have a diagnosable psychiatriccondition.

Allan House, Senior lecturer in psychiatry.
Division of Psychiatry and Behavioural Sciences in Relation to Medicine, School of Medicine, University of Leeds, Leeds LS2 9LT

1.	Kessler D, Lloyd K, Lewis G, Gray DP. Cross sectional study of symptom attribution and recognition of depression and anxiety in primary care [with commentary by I Heath]. BMJ 1999; 318: 436-440[Abstract/Free Full Text]. (13 February.)

Authors' reply

EDITOR $---$ Our paper had a hostile commentary from Heath. She ignored the substance of what we were saying about the importanceof patients' attributional styles and criticised the use of thegeneral health questionnaire¹ as a screening instrument fordepression and anxiety in general practice. Johnstone and Talbothave little to add to Heath's criticisms.² Like her, they ignorethe main body of . . . [Full text of this article]

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