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Recognition of depression and anxiety in primary care

BMJ 1999; 318 doi: (Published 05 June 1999) Cite this as: BMJ 1999;318:1558

Patients' attributional style is important factor

  1. Andrés Herrán, Associate professor. (,
  2. José Luis Vázquez-Barquero, Head professor,
  3. Graham Dunn, Professor of biomedical statistics.
  1. Clinical and Social Psychiatry Research Unit, Department of Psychiatry, University Hospital “Marqués de Valdecilla,” University of Cantabria, Santander 39008, Spain
  2. School of Epidemiology and Health Sciences, University of Manchester, Stopford Building, Manchester M13 9PT
  3. Belfast City Hospital, Belfast BT9 7AB

    EDITOR—Kessler et al found that doctors detected psychiatric illness in less than half of patients scoring highly on the general health questionnaire (85% of patients with a normalising attributional style and 38% with a psychologising style were not detected).1 These data are in accordance with the work that we did in four Spanish primary care centres. Using the general health questionnaire-28 in the first part of the study and a SCAN interview 2 3 in the second, we found similar figures of non-recognition of psychiatric illness4 and the same relevance of somatisation to lower rates of recognition of mental illness by general practitioners.5

    In her commentary on the paper Heath doubts that scoring highly on the general health questionnaire could be equated with having a treatable disorder. We agree with her that the general health questionnaire is a screening questionnaire, not a diagnostic tool, and that doctors should not talk of depression and anxiety just because patients scored highly on the questionnaire. …

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