Resumen de Somatic and psychiatric co-morbidity in Primary Care patients in Spain
Antonio Lobo Satué, Ricardo Campos Ródenas, Guillermo Marcos Aragües, Javier García Campayo, Raúl López Antón, María Jesús Pérez Echevarría
There is limited information on the subject of co-morbidity of general medical conditions (GMCs) and general psychiatric disturbance in primary care (PC). Methods: A representative sample (n = 1559) of adult PC patients was examined in a two-phase screening. Standardized screening instruments were used, including the Standardized Polyvalent Psychiatric Interview (SPPI). ICD-10 research criteria were used for psychiatric diagnosis, and ICPC-2 for medical diagnosis. Results: Most co-morbidity cases had depressive (120 cases, 28.1%) or anxiety/neurotic disorders (217 cases, 50.9%). In support of the working hypothesis, the proportion of patients with several medical diagnoses was significantly higher among the cases, and logistic regression showed that the probability of being a psychiatric case increased with each medical diagnosis done by the primary care physician (OR = 2.46; IC 1.66-3.66, p < 0.001). Moderate/severe cases were significantly more frequent among the depressed group (91 cases, 75.9%), but were also common in the anxiety/neurosis group (52 cases, 24%), the between groups differences in disability being non-significant. The distribution of both affective and neurotic disorders by specific ICPC-2 categories suggests preferential associations. Conclusion: In PC, the probability of having a co-morbid psychiatric diagnosis doubles with each medical diagnosis. Anxiety/neurotic disorders, and not only depressive disorders, are relevant co-morbid psychiatric categories in this setting.
