Recognition of depression and anxiety in primary care

doi:10.1136/bmj.319.7204.254b

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General practitioners in study seemed to agree with commentary writer

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
Institute of General Practice, Postgraduate Medical School, University of Exeter, Exeter EX2 5DW
Department of Mental Health, University of Exeter, Wonford House Hospital, Exeter EX2 5AF
Division of Psychological Medicine, University of Wales College of Medicine, Cardiff CF4 4XN

EDITOR—Kessler et al assessed the ability of general practitioners to diagnose depression and anxiety as defined by the general health questionnaire (GHQ-12).1 Unfortunately, they have miscalculated their results; from their data, the general practitioners had a 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 opinion in her commentary.1 Most patients with a score >3 on the general health questionnaire do not have a diagnosable psychiatric condition.

References

1.↵
1. Kessler D,
2. Lloyd K,
3. Lewis G,
4. 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.
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Authors' reply

David Kessler, Honorary research fellow,
Denis Pereira Gray, Professor of general practice,
Keith Lloyd, Senior lecturer,
Glyn Lewis, Professor of community and epidemiological psychiatry

Division of Psychiatry and Behavioural Sciences in Relation to Medicine, School of Medicine, University of Leeds, Leeds LS2 9LT
Institute of General Practice, Postgraduate Medical School, University of Exeter, Exeter EX2 5DW
Department of Mental Health, University of Exeter, Wonford House Hospital, Exeter EX2 5AF
Division of Psychological Medicine, University of Wales College of Medicine, Cardiff CF4 4XN

EDITOR—Our paper had a hostile commentary from Heath. She ignored the substance …