Landa González Natalia, Goñi Sarriés Adriana, García de Jalón Aramayo Elena, Lizasoain Urra Eva
Centro de Salud Mental de Estella. Navarra. España.
Aten Primaria. 2008 Jun;40(6):285-9. doi: 10.1157/13123680.
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.
分析初级保健与心理健康之间的诊断一致性指数。
回顾性描述性研究。
西班牙纳瓦拉省埃斯特拉的心理健康中心。参与者：2002年7月至2005年3月期间连续转诊至心理健康科的成年新患者（n = 1005）。
分析该时间段内初级保健和心理健康方面做出的诊断。计算观察者间一致性的kappa指数。
总体诊断一致性的kappa指数 = 0.385（±0.018）。酒精及其他物质使用障碍和精神障碍的一致性指数较高（>0.7）。进食障碍和器质性精神障碍的一致性指数中等（0.4 - 0.7）。然而，焦虑、适应性和情感障碍的一致性指数较低（<0.3）。
总体而言，初级保健与心理健康之间的诊断一致性较弱。特别值得注意的是，在充分识别适应性障碍方面存在困难。初级保健中存在将这些障碍误诊为焦虑或情感障碍的强烈倾向。
