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  1. Diagnosis of depression by primary Care physicians versus a structured Diagnostic interview : Understanding discordance.

    Article - En anglais

    In this paper, false-negative and false-positive cases of depressive illness are examined, differentiating levels of disagreement between a primary care physician's diagnosis and a standardized research diagnosis.

    Two stratified random samples of primary care patients in Seattle, USA (N=373) and Groningen, The Netherlands (N=340) were examined with the Composite International Diagnostic Interview-Primary Health Care Version (CIDI-PHC).

    Physician's severity ratings and diagnosis of psychological disorder were obtained.

    Three levels of disagreement between physician and CIDI diagnosis were distinguished : 1) complete disagreement about the presence of psychiatric symptoms (true false-negative and true false-positive patients) ; 2) disagreement over severity of recognized psychological illness (underestimated or overestimated) ; and 3) disagreement over the specific psychiatric diagnosis among those given a diagnosis (misdiagnosed or given another CIDI diagnosis).

    All three levels of disagreement were common.

    Only 27% of the false-negative cases were due to complete disagreement (true false-negatives), and 55% of the false-positives were due to complete disagreement (true false-positives).

    The true false-negative patients were younger, more often employed, rated their own health more favorably, visited their doctor for a somatic complaint and made fewer visits than the underestimated, misdiagnosed, and concordant positive patients. (...)

    Mots-clés Pascal : Etat dépressif, Diagnostic, Médecin généraliste, Etude comparative, Entretien directif, Psychométrie, Accord interjuge, Soin santé primaire, Homme, Trouble humeur

    Mots-clés Pascal anglais : Depression, Diagnosis, General practitioner, Comparative study, Directive interview, Psychometrics, Interrater agreement, Primary health care, Human, Mood disorder

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0349333

    Code Inist : 002B18C07A. Création : 14/12/1999.