The primary health care version of ICD-11: the detection of common mental disorders in general medical settings
Abstract
Background The primary health care version of the ICD-11 is currently being revised.Aim To test two brief sets of symptoms for depression and anxiety in primary care settings, and validate them against diagnoses of major depression and current generalised anxiety made by the CIDI.Method The study took place in general medical or primary care clinics in 14 different countries, using the Composite International Diagnostic Interview adapted for primary care (CIDI-PC) in 5,438 patients. The latent structure of common symptoms was explored, and two symptom scales were derived from item response theory (IRT), these were then investigated against research diagnoses.Results Correlations between dimensions of anxious, depressive and somatic symptoms were found to be high. For major depression the 5 item depression scale has marked superiority over the usual 2 item scales used by both the ICD and DSM systems, and for anxiety there is some superiority. If the questions are used with patients that the clinician suspects may have a psychological disorder, the positive predictive value of the scale is between 78 and 90%.Conclusion The two scales allow clinicians to make diagnostic assessments of depression and anxiety with a high positive predictive value, provided they use them only when they suspect that a psychological disorder is present.
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Of the five DSM-5 anxious distress specifier symptoms, four are typical for generalized anxiety disorder and one for panic disorder.
“Of these, four out of five symptoms are typical for generalized anxiety disorder (GAD) and one for panic disorder [23].”
From Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome (2018) · cites this paper as [23]
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- Authors
- Goldberg, D. P., Prisciandaro, J. J., & Williams, P.
- Affiliations
- King's College London (GB)
- Medical University of South Carolina (US)
- Corresponding author
- Prisciandaro, James J.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-11
- Volume
- 34
- Issue
- 6
- Pages
- 665-670
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2074390663
- Cited by
- 48
- References
- 23
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 1 · 2022: 5 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 4 · 2012: 2
- FWCI
- 4.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- ICD-11, common mental disorders, depression, generalized anxiety disorder, primary care diagnosis, item response theory, positive predictive value, somatic symptoms
- MeSH terms
- Anxiety Disorders, Depressive Disorder, Major, Major Depressive Disorder, Humans, Interview, Psychological, Predictive Value of Tests, Primary Health Care, Psychometrics, ROC Curve, Sensitivity and Specificity, Reproducibility of Results, International Classification of Diseases
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