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Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Common adult psychiatric disorders in Swedish primary care where most mental health patients are treated

Authors: Jan Sundquist, Henrik Ohlsson, Kristina Sundquist, Kenneth S. Kendler

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

The overall aim of this study is to present descriptive data regarding the treated prevalence of nine common psychiatric and substance use disorders in the first Primary Care Registry (PCR) in Sweden: Major Depression (MD), Anxiety Disorders (AD), Obsessive-Compulsive Disorder (OCD), Adjustment Disorder (AdjD), Eating Disorders (ED), Personality Disorder (PD), Attention Deficit Hyperactivity Disorder (ADHD), Alcohol Use Disorder (AUD) and Drug Abuse (DA).

Method

We selected 5,397,675 individuals aged ≥18. We examined patterns of comorbidity among these disorders and explored the association between diagnoses in the PCR and diagnoses obtained from Hospital and Specialist care. We explored the proportion of patients with these nine disorders that are only treated in primary health care.

Results

For four of our disorders, 80% or more of the cases were present only in the PCR: AdjD, DA, AD and MD. For two disorders (OCD and ED), 65–70% of cases were only found in the PCR. For three disorders (PD, AUD, and ADHD), 45–55% of the patients were only present in the PCR.

Conclusion

The PCR will, in the future, likely prove to be an important tool for studies in psychiatric epidemiology.
Literature
1.
go back to reference Försäkringskassan: Vad kostar olika sjukdomar i sjukförsäkringen? Kostnader för sjukpenning i sjukskrivningar (över 14 dagar) samt sjukersättning och aktivitetsersättning år 2009 fördelat på diagnos (What are the costs for different diseases in Swedish sickness insurance? The cost of sick leave for reporting sick (over 14 days) and sickness compensation and active compensation in 2009 based on diagnoses). In.: Swedish Social Insurance Agency; 2011. Försäkringskassan: Vad kostar olika sjukdomar i sjukförsäkringen? Kostnader för sjukpenning i sjukskrivningar (över 14 dagar) samt sjukersättning och aktivitetsersättning år 2009 fördelat på diagnos (What are the costs for different diseases in Swedish sickness insurance? The cost of sick leave for reporting sick (over 14 days) and sickness compensation and active compensation in 2009 based on diagnoses). In.: Swedish Social Insurance Agency; 2011.
2.
go back to reference Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet (London, England). 2012;380(9859):2163–96.CrossRef Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, Ezzati M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet (London, England). 2012;380(9859):2163–96.CrossRef
3.
go back to reference Bodlund O. Anxiety and depression as a hidden problem in primary health care. Only one case in four identified. Lakartidningen. 1997;94(49):4612–4. 4617-4618PubMed Bodlund O. Anxiety and depression as a hidden problem in primary health care. Only one case in four identified. Lakartidningen. 1997;94(49):4612–4. 4617-4618PubMed
4.
go back to reference Nordstrom A, Bodlund O. Every third patient in primary care suffers from depression, anxiety or alcohol problems. Nordic journal of psychiatry. 2008;62(3):250–5.CrossRefPubMed Nordstrom A, Bodlund O. Every third patient in primary care suffers from depression, anxiety or alcohol problems. Nordic journal of psychiatry. 2008;62(3):250–5.CrossRefPubMed
5.
go back to reference Martin-Merino E, Ruigomez A, Johansson S, Wallander MA, Garcia-Rodriguez LA. Study of a cohort of patients newly diagnosed with depression in general practice: prevalence, incidence, comorbidity, and treatment patterns. Primary care companion to the Journal of clinical psychiatry. 2010;12(1):PCC.08m00764.PubMedPubMedCentral Martin-Merino E, Ruigomez A, Johansson S, Wallander MA, Garcia-Rodriguez LA. Study of a cohort of patients newly diagnosed with depression in general practice: prevalence, incidence, comorbidity, and treatment patterns. Primary care companion to the Journal of clinical psychiatry. 2010;12(1):PCC.08m00764.PubMedPubMedCentral
6.
go back to reference Martin-Merino E, Ruigomez A, Wallander MA, Johansson S, Garcia-Rodriguez LA. Prevalence, incidence, morbidity and treatment patterns in a cohort of patients diagnosed with anxiety in UK primary care. Fam Pract. 2010;27(1):9–16.CrossRefPubMed Martin-Merino E, Ruigomez A, Wallander MA, Johansson S, Garcia-Rodriguez LA. Prevalence, incidence, morbidity and treatment patterns in a cohort of patients diagnosed with anxiety in UK primary care. Fam Pract. 2010;27(1):9–16.CrossRefPubMed
7.
go back to reference Boffin N, Bossuyt N, Declercq T, Vanthomme K, Van Casteren V. Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study. Fam Pract. 2012;29(6):678–87.CrossRefPubMed Boffin N, Bossuyt N, Declercq T, Vanthomme K, Van Casteren V. Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study. Fam Pract. 2012;29(6):678–87.CrossRefPubMed
8.
go back to reference Lejtzen N, Sundquist J, Sundquist K, Li X. Depression and anxiety in Swedish primary health care: prevalence, incidence, and risk factors. Eur Arch Psychiatry Clin Neurosci. 2014;264(3):235–45.CrossRefPubMed Lejtzen N, Sundquist J, Sundquist K, Li X. Depression and anxiety in Swedish primary health care: prevalence, incidence, and risk factors. Eur Arch Psychiatry Clin Neurosci. 2014;264(3):235–45.CrossRefPubMed
9.
go back to reference Crump C, Winkleby MA, Sundquist K, Sundquist J. Comorbidities and mortality in persons with schizophrenia: a Swedish national cohort study. Am J Psychiatry. 2013;170(3):324–33.CrossRefPubMed Crump C, Winkleby MA, Sundquist K, Sundquist J. Comorbidities and mortality in persons with schizophrenia: a Swedish national cohort study. Am J Psychiatry. 2013;170(3):324–33.CrossRefPubMed
10.
go back to reference Sundquist J, Ohlsson H, Sundquist K, Kendler KS. Attention-deficit/hyperactivity disorder and risk for drug use disorder: a population-based follow-up and co-relative study. Psychol Med. 2015;45(5):977–83.CrossRefPubMed Sundquist J, Ohlsson H, Sundquist K, Kendler KS. Attention-deficit/hyperactivity disorder and risk for drug use disorder: a population-based follow-up and co-relative study. Psychol Med. 2015;45(5):977–83.CrossRefPubMed
11.
go back to reference Kendler KS, Ohlsson H, Sundquist K, Sundquist J. Peer deviance, parental divorce, and genetic risk in the prediction of drug abuse in a nationwide Swedish sample: evidence of environment-environment and gene-environment interaction. JAMA psychiatry. 2014;71(4):439–45.CrossRefPubMedPubMedCentral Kendler KS, Ohlsson H, Sundquist K, Sundquist J. Peer deviance, parental divorce, and genetic risk in the prediction of drug abuse in a nationwide Swedish sample: evidence of environment-environment and gene-environment interaction. JAMA psychiatry. 2014;71(4):439–45.CrossRefPubMedPubMedCentral
12.
go back to reference Sundquist J, Ohlsson H, Winkleby MA, Sundquist K, Crump C. School Achievement and Risk of Eating Disorders in a Swedish National Cohort. Journal of the American Academy of Child and Adolescent Psychiatry. 2016;55(1):41–46.e41.CrossRefPubMed Sundquist J, Ohlsson H, Winkleby MA, Sundquist K, Crump C. School Achievement and Risk of Eating Disorders in a Swedish National Cohort. Journal of the American Academy of Child and Adolescent Psychiatry. 2016;55(1):41–46.e41.CrossRefPubMed
13.
go back to reference Sundquist K, Li X, Hemminki K, Sundquist J. Subsequent risk of hospitalization for neuropsychiatric disorders in patients with rheumatic diseases: a nationwide study from Sweden. Arch Gen Psychiatry. 2008;65(5):501–7.CrossRefPubMed Sundquist K, Li X, Hemminki K, Sundquist J. Subsequent risk of hospitalization for neuropsychiatric disorders in patients with rheumatic diseases: a nationwide study from Sweden. Arch Gen Psychiatry. 2008;65(5):501–7.CrossRefPubMed
14.
go back to reference Kendler KS, Maes HH, Sundquist K, Ohlsson H, Sundquist J. Genetic and family and community environmental effects on drug abuse in adolescence: a Swedish national twin and sibling study. Am J Psychiatry. 2014;171(2):209–17.CrossRefPubMedPubMedCentral Kendler KS, Maes HH, Sundquist K, Ohlsson H, Sundquist J. Genetic and family and community environmental effects on drug abuse in adolescence: a Swedish national twin and sibling study. Am J Psychiatry. 2014;171(2):209–17.CrossRefPubMedPubMedCentral
15.
go back to reference Robins E, Guze SB. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970;126(7):983–7.CrossRefPubMed Robins E, Guze SB. Establishment of diagnostic validity in psychiatric illness: its application to schizophrenia. Am J Psychiatry. 1970;126(7):983–7.CrossRefPubMed
16.
go back to reference Anonymous: SAS Institute, SAS/STAT User's Guide, Version 9.3. Cary, NC.; 2011. Anonymous: SAS Institute, SAS/STAT User's Guide, Version 9.3. Cary, NC.; 2011.
17.
18.
go back to reference Kendler KS, Aggen SH, Knudsen GP, Roysamb E, Neale MC, Reichborn-Kjennerud T. The structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV axis I and all axis II disorders. Am J Psychiatry. 2011;168(1):29–39.CrossRefPubMed Kendler KS, Aggen SH, Knudsen GP, Roysamb E, Neale MC, Reichborn-Kjennerud T. The structure of genetic and environmental risk factors for syndromal and subsyndromal common DSM-IV axis I and all axis II disorders. Am J Psychiatry. 2011;168(1):29–39.CrossRefPubMed
19.
go back to reference Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA. 1996;276(4):293–9.CrossRefPubMed Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA. 1996;276(4):293–9.CrossRefPubMed
20.
go back to reference Kringlen E, Torgersen S, Cramer V. A Norwegian psychiatric epidemiological study. Am J Psychiatry. 2001;158(7):1091–8.CrossRefPubMed Kringlen E, Torgersen S, Cramer V. A Norwegian psychiatric epidemiological study. Am J Psychiatry. 2001;158(7):1091–8.CrossRefPubMed
21.
go back to reference Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51(1):8–19.CrossRefPubMed Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51(1):8–19.CrossRefPubMed
22.
go back to reference Fryers T, Brugha T, Morgan Z, Smith J, Hill T, Carta M, et al. Prevalence of psychiatric disorder in Europe: the potential and reality of meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2004;39(11):899–905.CrossRefPubMed Fryers T, Brugha T, Morgan Z, Smith J, Hill T, Carta M, et al. Prevalence of psychiatric disorder in Europe: the potential and reality of meta-analysis. Soc Psychiatry Psychiatr Epidemiol. 2004;39(11):899–905.CrossRefPubMed
23.
go back to reference Brugha TS, Matthews R, Alonso J, Vilagut G, Fouweather T, Bruffaerts R, et al. Gender differences in mental health expectancies in early- and midlife in six European countries. The British journal of psychiatry : the journal of mental science. 2013;202(4):294–300.CrossRef Brugha TS, Matthews R, Alonso J, Vilagut G, Fouweather T, Bruffaerts R, et al. Gender differences in mental health expectancies in early- and midlife in six European countries. The British journal of psychiatry : the journal of mental science. 2013;202(4):294–300.CrossRef
24.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.CrossRefPubMed Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602.CrossRefPubMed
25.
go back to reference Grant BF, Goldstein RB, Chou SP, Huang B, Stinson FS, Dawson DA, et al. Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Mol Psychiatry. 2009;14(11):1051–66.CrossRefPubMed Grant BF, Goldstein RB, Chou SP, Huang B, Stinson FS, Dawson DA, et al. Sociodemographic and psychopathologic predictors of first incidence of DSM-IV substance use, mood and anxiety disorders: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. Mol Psychiatry. 2009;14(11):1051–66.CrossRefPubMed
26.
go back to reference Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry. 2000;157(10):1552–62.CrossRefPubMed Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry. 2000;157(10):1552–62.CrossRefPubMed
27.
go back to reference Hettema JM, Neale MC, Kendler KS. A review and meta-analysis of the genetic epidemiology of anxiety disorders. Am J Psychiatry. 2001;158(10):1568–78.CrossRefPubMed Hettema JM, Neale MC, Kendler KS. A review and meta-analysis of the genetic epidemiology of anxiety disorders. Am J Psychiatry. 2001;158(10):1568–78.CrossRefPubMed
28.
29.
go back to reference Merikangas KR, Stolar M, Stevens DE, Goulet J, Preisig MA, Fenton B, et al. Familial transmission of substance use disorders. Arch Gen Psychiatry. 1998;55(11):973–9.CrossRefPubMed Merikangas KR, Stolar M, Stevens DE, Goulet J, Preisig MA, Fenton B, et al. Familial transmission of substance use disorders. Arch Gen Psychiatry. 1998;55(11):973–9.CrossRefPubMed
30.
go back to reference Bulik CM, Sullivan PF, Wade TD, Kendler KS. Twin studies of eating disorders: a review. The International journal of eating disorders. 2000;27(1):1–20.CrossRefPubMed Bulik CM, Sullivan PF, Wade TD, Kendler KS. Twin studies of eating disorders: a review. The International journal of eating disorders. 2000;27(1):1–20.CrossRefPubMed
Metadata
Title
Common adult psychiatric disorders in Swedish primary care where most mental health patients are treated
Authors
Jan Sundquist
Henrik Ohlsson
Kristina Sundquist
Kenneth S. Kendler
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1381-4

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