Concordancia en el diagnóstico entre atención primaria y salud mental

Abstract

To analyse the diagnostic concordance index between primary care and mental health. Retrospective and descriptive study. Mental health centre, Estella, Navarra, Spain. PARTICIPANTS. New consecutive adults patients referred to mental health (n=1005) from july 2002 to march 2005. Analysis of diagnoses made in primary care and mental health during the time period. Calculation of kappa index for inter-observer concordance. General diagnostic concordance had a kappa index =0.385 (+/-0.018). High concordance index (>0.7) was obtained for alcohol and other substance use disorders and psychotic disorders. Moderate concordance index (0.4-0.7) was obtained for eating disorders and organic mental disorders. However, low concordance index (<0.3) was obtained for anxiety, adaptative, and affective disorders. In general, diagnostic concordance between primary care and mental health is weak. Particularly noticeable was difficulty in identifying adaptative disorders adequately. There was a strong tendency in primary care to identify these disorders as anxiety or affective disorders.