Bodlund O
Psykiatriska institutionen och kliniken, Norrlands Universitetssjukhus, Umeå.
Lakartidningen. 1997 Dec 3;94(49):4612-4, 4617-8.
Of 374 unselected primary care patients assessed with the Hospital Anxiety and Depression (HAD) scale, 11.8 per cent rated themselves as suffering from anxiety, and 3.7 per cent as depressed. Clinically, 8 per cent were diagnosed as cases of anxiety, and 4 per cent as cases of depression, but agreement was very poor between these cases and those elicited with the HAD scale, only 25 per cent of the latter being identified by the primary care physicians. One third of the patients with a clinical diagnosis of anxiety and 47 per cent of those with diagnosed depression were offered appropriate treatment, usually medication with a selective serotonin re-uptake inhibitor (SSRI) and consultation with a medical social worker. The results were consistent with the expected prevalences, thus indicating anxiety and depression to be markedly under-diagnosed and under-treated, and suggest that there is a manifest need of consultation facilities and of further education among primary care physicians.
在374名未经过挑选、使用医院焦虑抑郁量表（HAD）进行评估的初级保健患者中，11.8%的患者自评患有焦虑症，3.7%的患者自评患有抑郁症。临床上，8%的患者被诊断为焦虑症，4%的患者被诊断为抑郁症，但这些病例与通过HAD量表得出的病例之间的一致性很差，只有25%的后者被初级保健医生识别出来。临床诊断为焦虑症的患者中有三分之一以及诊断为抑郁症的患者中有47%接受了适当的治疗，通常是使用选择性5-羟色胺再摄取抑制剂（SSRI）药物治疗并与医务社会工作者进行咨询。结果与预期患病率一致，因此表明焦虑症和抑郁症明显诊断不足且治疗不足，并表明初级保健医生明显需要咨询设施和进一步教育。
