Screening for anxiety, depression, and anxious depression in primary care: a field study for ICD-11 PHC
Open accessAbstract
BACKGROUND: In this field study of WHO's revised classification of mental disorders for primary care settings, the ICD-11 PHC, we tested the usefulness of two five-item screening scales for anxiety and depression to be administered in primary care settings. METHODS: The study was conducted in primary care settings in four large middle-income countries. Primary care physicians (PCPs) referred individuals who they suspected might be psychologically distressed to the study. Screening scales as well as a structured diagnostic interview, the revised Clinical Interview Schedule (CIS-R), adapted for proposed decision rules in ICD-11 PHC, were administered to 1488 participants. RESULTS: A score of 3 or more on one or both screening scale predicted 89.6% of above-threshold mood or anxiety disorder diagnoses on the CIS-R. Anxious depression was the most common CIS-R diagnosis among referred patients. However, there was an exact diagnostic match between the screening scales and the CIS-R in only 62.9% of those with high scores. LIMITATIONS: This study was confined to those in whom the PCP suspected psychological distress, so does not provide information about the prevalence of mental disorders in primary care settings. CONCLUSIONS: The two five-item screening scales for anxiety and depression provide a practical way for PCPs to evaluate the likelihood of mood and anxiety disorders without paper and pencil measures that are not feasible in many settings. These scales may provide substantially improved case detection as compared to current primary care practice and a realistic alternative to complex diagnostic algorithms used by specialist mental health professionals.
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Vega‐Dienstmaier, J. M. (2022) · Revista de Neuro-Psiquiatría · doi:10.20453/rnp.v85i2.4230 · Cited by 2 · see citing works
Überblick über die Veränderungen in der ICD-11 im Bereich der affektiven Störungen
Völz, H., & Köhler, S. (2024) · Nervenheilkunde · doi:10.1055/a-2261-8292 · Cited by 2 · see citing works
WHO’s ICD-11 for Primary Health Care
Robles, R., Dirección de investigaciones Epidemiológicas y Psicosociales, I. N. D. P. R. D. L. F. M., & Reed, G. M. (2017) · Salud Mental · doi:10.17711/sm.0185-3325.2017.006 · Cited by 2 · see citing works
Community-Based Mental Health Services in Mexico
Oropeza, M. C., Berenzon, S., Robles, R., Real, T., & Medina‐Mora, M. E. (2021) · Consortium Psychiatricum · doi:10.17816/cp86 · Cited by 2 · see citing works
Riesgos a la Salud Mental de las Personas Cuidadoras durante la Pandemia por COVID-19 en México
Salcedo-Gómez, M., Chainé, S. M., Cruz, C. L. T. S., Valdés, B. R., Montoya, A. L., Robles, R., Maldonado, A. B., Aguirre, A. G. B., & Palafox, G. P. (2022) · Acta de Investigación Psicológica · doi:10.22201/fpsi.20074719e.2022.3.459 · Cited by 2 · see citing works
Chainé, S. M., Bacigalupe, G., Robles, R., Fuentes, A. L. L., & Romero, V. F. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22060955 · Cited by 1 · see citing works
Chainé, S. M., Bacigalupe, G., Robles, R., & Fuentes, A. L. L. (2024) · Revista Internacional de Investigación en Adicciones · doi:10.28931/riiad.2024.1.02 · Cited by 1 · see citing works
Yoldi‐Negrete, M., Guízar-Sánchez, D., Robles, R., Tovilla‐Zárate, C. A., Saracco-Álvarez, R. A., Navarro-Castellanos, I., Hill-de-Titto, A.-C., & Fresán, A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1346530 · Cited by 1 · see citing works
International classification of Diseases-11: Primary care perspective
Razzaque, B., & Minhas, F. (2018) · Indian Journal of Social Psychiatry · doi:10.4103/ijsp.ijsp_77_17 · Cited by 1 · see citing works
Adaptation and Psychometric Study of the Coronavirus Anxiety Scale (CAS) to the Mexican Population
Blázquez, F. P., Trujillo-Alonso, G., Salinas-García, P., Reséndiz-Ramírez, Y., González-García, C. L., Montoya-Pérez, R. D. C., & Martínez-Medina, M. P. (2021) · Psychology · doi:10.4236/psych.2021.1211108 · Cited by 1 · see citing works
Cognitive behavioural therapy in patients with an implanted cardioverter defibrillator
Höfer, S. (2019) · European Journal of Preventive Cardiology · doi:10.1177/2047487319884375
Coussement, C., & Heeren, A. (2020) · doi:10.31234/osf.io/ynrkj
Szlenk-Czyczerska, E., Guzek, M., Prusaczyk, A., Bielska, D., Ławnik, A., Polański, P., & Kurpas, D. (2019) · doi:10.21203/rs.2.16497/v2
Lotfy, A. M. M., Alharbi, B. S. D., Alharbi, W. S. D., & Abd‐Ellatif, E. E. (2021) · Global Journal of Health Science · doi:10.5539/gjhs.v13n12p25
Preventing Anxiety Disorders in Integrated Care
Willis, B., & Zimmermann, M. (2021) · Springer eBooks · doi:10.1007/978-3-030-83469-2_7
Coussement, C., & Heeren, A. (2020) · doi:10.31219/osf.io/m8z6w
Szlenk-Czyczerska, E., Guzek, M., Prusaczyk, A., Bielska, D., Ławnik, A., Polański, P., & Kurpas, D. (2019) · doi:10.21203/rs.2.16497/v1
Chainé, S. M., Montoya, A. L., Maldonado, A. B., Aguirre, A. G. B., Robles, R., Santacruz, C. L. T., Palafox, G. P., & Fernández-Cáceres, C. (2023) · Revista Internacional de Investigación en Adicciones · doi:10.28931/riiad.2023.1.07
Пелех, І., & Гринишин, Н. (2024) · Наукові перспективи (Naukovì perspektivi) · doi:10.52058/2708-7530-2024-1(43)-892-902
Rubio, C. R. G., Yamori, K., Nakano, G., Gutiérrez, A. R. P., Chainé, S. M., Robles, R., Landa-Ramírez, É., Estrada, A. B., Maldonado, A. B., & Orozco, D. I. T. (2024) · Data in Brief · doi:10.1016/j.dib.2024.110877
Khoury, M. A. E., Malaeb, D. N., Sakr, F., Dabbous, M., Fekih‐Romdhane, F., Hallit, S. R., & Obeïd, S. (2024) · Research Square · doi:10.21203/rs.3.rs-4938503/v1
Chainé, S. M., Bacigalupe, G., Robles, R., Fuentes, A. L. L., & Romero, V. F. (2024) · Research Square · doi:10.21203/rs.3.rs-4836554/v1
Samaha, S., Malaeb, D. N., Sakr, F., Dabbous, M., Hallit, S. R., Fekih‐Romdhane, F., & Obeïd, S. (2024) · Research Square · doi:10.21203/rs.3.rs-5353747/v1
Rubio, C. R. G., Nakano, G., Yamori, K., Gutiérrez, A. R. P., Chainé, S. M., Robles, R., Landa-Ramírez, É., Estrada, A. B., & Orozco, D. I. T. (2026) · Humanities and Social Sciences Communications · doi:10.1057/s41599-026-09201-9
Risk factors for psychological distress in oncologists
Robles-García, R., Yoldi‐Negrete, M., Guízar-Sánchez, D., Tovilla‐Zárate, C. A., Saracco-Álvarez, R. A., & Fresán, A. (2026) · Psychology Health & Medicine · doi:10.1080/13548506.2026.2627580
Behind the Mask: Risk Profiles of Depression and Anxiety in Anesthesiology Residents
Guízar-Sánchez, D., Fresán, A., Saracco-Álvarez, R. A., Yoldi‐Negrete, M., Robles, R., & Tovilla‐Zárate, C. A. (2026) · Depression and Anxiety · doi:10.1155/da/9253231
Psychometric properties of the Arabic Fear of Happiness Scale in a sample of Lebanese adults
Khoury, M. A. E., Malaeb, D. N., Sakr, F., Dabbous, M., Fekih‐Romdhane, F., Hallit, S. R., & Obeïd, S. (2026) · PLoS ONE · doi:10.1371/journal.pone.0356389
Chainé, S. M., Fuentes, A. L. L., Duarte-Martínez, G. A., Chávez, I. A. L., Bacigalupe, G., Robles, R., Mora, M. E. M., & Rangel-Gomez, M. G. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1975732
- Authors
- Goldberg, D. P., Reed, G. M., Robles, R., Minhas, F., Razzaque, B., Fortes, S., Mari, J. D. J., Lam, T. P., Garcia, J. Á., Gask, L., Dowell, A. C., Rosendal, M., Mbatia, J. K., & Saxena, S.
- Affiliations
- King's College London (GB)
- Columbia University Irving Medical Center (US)
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- Universidade do Estado do Rio de Janeiro (BR)
- Universidade Federal de São Paulo (BR)
- University of Hong Kong (HK)
- University of Manchester (GB)
- University of Otago (NZ)
- University of Southern Denmark (DK)
- Sebastian Kolowa Memorial University (TZ)
- World Health Organization (CH)
- Corresponding author
- Goldberg, David P.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 213
- Pages
- 199-206
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2590313431
- Cited by
- 80
- References
- 43
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 11 · 2023: 8 · 2022: 10 · 2021: 14 · 2020: 7 · 2019: 9 · 2018: 9 · 2017: 4
- FWCI
- 11.36
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (publishedVersion, cc-by-nc-nd)
- Research Explorer (The University of Manchester) (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, cc-by-nc-nd)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- World Health Organization
- Psychiatry Research Trust of Institute of Psychiatry, London
- National Research Council CNPQ, Brazil (476905/2012-5)
- Committee on Research and Conference Grants
- University of Hong Kong
- National Council of Science and Technology (SALUD-2013-01-202283)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- anxiety screening, depression screening, anxious depression, primary care, mood disorders, anxiety disorders, psychological distress, case finding, diagnostic accuracy
- MeSH terms
- Adult, Aged, Anxiety Disorders, Depressive Disorder, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychometrics, Stress, Psychological, Mood Disorders
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