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BMC Psychiatry
Published in: BMC Psychiatry 1/2018

Open Access 01-12-2018 | Research article

Diagnosis of somatoform disorders in primary care: diagnostic agreement, predictors, and comaprisons with depression and anxiety

Authors: Katharina Piontek, Meike C. Shedden-Mora, Maria Gladigau, Amina Kuby, Bernd Löwe

Published in: BMC Psychiatry | Issue 1/2018

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Abstract

Background

To investigate (a) the diagnostic agreement between diagnoses of somatoform disorders, depressive and anxiety disorders obtained from a structured clinical interview and diagnoses reported from primary care physicians (PCPs) and (b) to identify patient and PCP-related predictors for the diagnostic agreement regarding the presence of a somatoform disorder.

Methods

Data from a cross-sectional study comprising 112 primary care patients at high risk for somatoform disorders were analyzed. Diagnoses according to International Classification of Diseases, 10th revision (ICD-10) for somatoform, depressive and anxiety disorders were obtained from the Composite International Diagnostic Interview (CIDI) and compared with the diagnoses of the patients’ PCPs documented in their medical records. Using multiple regression analyses, predictors for the PCPs’ diagnosis of a somatoform disorder were analyzed.

Results

The agreement between PCP diagnoses and CIDI diagnoses was 32.3% for somatoform disorders, 48.0% for depressive disorders and 25.0% for anxiety disorders. Multiple regression analyses revealed the likelihood of being diagnosed with a somatoform disorder by PCP increased with somatic symptom severity (OR = 1.22, 95% CI 1.03–1.44). Regarding PCP-related characteristics, a specialization in internal medicine (OR = 5.95, 95% CI 1.70–20.80) and working in a solo practice (OR = 2.92, 95% CI 1.02–8.38) increased the likelihood that patients were diagnosed with a somatoform disorder.

Conclusions

The present results indicate that the process of diagnosing somatoform disorders in primary care needs to be improved. Findings further underline the necessity to implement appropriate strategies to improve early detection of patients.

Trial registration

ISRCTN ISRCTN55870770. Registered 22 October 2014. Retrospectively registered.
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Metadata
Title
Diagnosis of somatoform disorders in primary care: diagnostic agreement, predictors, and comaprisons with depression and anxiety
Authors
Katharina Piontek
Meike C. Shedden-Mora
Maria Gladigau
Amina Kuby
Bernd Löwe
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-018-1940-3

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