Menu

A+ A A-

Download article

DOI: https://doi.org/10.22263/2312-4156.2020.5

Kirpichenka A.A., Baryshau A.N.
Anxiety and depression screening in general medical practice: the current state of the matter
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2020;19(5):8-16.

Abstract.
Screening of anxiety and depression disorders in general medical practice is a very important problem of modern medicine. In this literature review, the authors summarize and systematize scattered and conflicting data regarding the screening of anxiety and depressive disorders, as well as make suggestions aimed at its optimization in general medical practice. The article focuses on current problems in the organization of screening and the main obstacles that prevent its effective introduction into general medical practice. The problematic issues of overdiagnosis of anxiety and depressive disorders and subsequent inadequate treatment, psychiatric stigma and additional labor input of doctors during outpatient visits are considered. Particular attention is drawn to the need to further optimize the screening of anxiety and depression in order to increase the effectiveness of providing psychiatric and psychotherapeutic care to patients in an outpatient network. For this, in the judgement of the authors, it is necessary to implement a number of changes at the legislative level in the very near future.
Key words: screening, anxiety, depression, general medical practice.

References

1. Reynolds CF, Patel V. Screening for depression: the global mental health context. World Psychiatry. 2017 Oct;16(3):316-317. doi: http://dx.doi.org/10.1002/wps.20459
2. Shimada F, Ohira Y, Hirota Y, Ikegami A, Kondo T, Shikino K, et al. Anxiety and depression in general practice outpatients: the long-term change process. Int J Gen Med. 2018 Feb;11:55-63. doi: http://dx.doi.org/10.2147/IJGM.S130025
3. Shalnova SA, Evstifeeva SE, Deev AD, Artamonova GV, Gatagonova TM, Dupliakov DV, i dr. The prevalence of anxiety and depression in various regions of the Russian Federation and its association with socio-demographic factors (according to the ESSE-RF study). Terapevt Arkh. 2014;86(12):53-60. (In Russ.)
4. On amendments to the Law of the Republic of Belarus «On the provision of psychiatric care»: Zakon Resp Belarus’, 11 noiab 2019 g, № 255-3. Nats tsentr pravovoi inform Resp Belarus’. V: Natsional’nyi Internet-portal Respubliki Belarus’ [Elektronnyi resurs]. Minsk, RB; 2020. Rezhim dostupa: http://pravo.by/document/?guid=3961&p0=H11900255. Data dostupa: 23.10.2020. (In Russ.)
5. On the approval of the clinical protocol «Diagnostics and treatment of patients with mental and behavioral disorders by general practitioners»: postanovlenie M-va zdravookhraneniia Resp Belarus’, 2 marta 2020 g, № 13. Nats tsentr pravovoi inform Resp Belarus’. V: Natsional’nyi Internet-portal Respubliki Belarus’ [Elektronnyi resurs]. Minsk, RB; 2020. Rezhim dostupa: http://pravo.by/upload/docs/op/W22035194p_1585602000.pdf. Data dostupa: 23.10.2020. (In Russ.)
6. Wіlson JMG, Jungner G. Prіncіples and Practіce of Screenіng for Dіsease. Geneva; 1968. 200 p.
7. Criteria for appraising the viability, effectiveness and appropriateness of a screening programme: guidance. Available from: https://www.gov.uk/government/publications/evidence-review-criteria-national-screening-programmes/criteria-for-appraising-the-viability-effectiveness-and-appropriateness-of-a-screening-programme. [Accessed 26th Oct 2020]
8. American Academy of Family Physicians. Clinical preventive service recommendation: depression. Available from: http://www.aafp.org/patient-care/clinical-recommendations/all/depression.html. [Accessed 26th Oct 2020]
9. Earls MF; Committee on Psychosocial Aspects of Child and Family Health American Academy of Pediatrics. Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics. 2010 Nov;126(5):1032-9. doi: http://dx.doi.org/10.1542/peds.2010-2348
10. Nimalasuriya K, Compton MT, Guillory VJ; Prevention Practice Committee of the American College of Preventive Medicine. Screening adults for depression in primary care: a position statement of the American College of Preventive Medicine. J Fam Pract. 2009 Oct;58(10):535-8.
11. Committee on Obstetric Practice. The American College of Obstetricians and Gynecologists Committee Opinion No. 630. Screening for perinatal depression. Obstet Gynecol. 2015 May;125(5):1268-71. doi: http://dx.doi.org/10.1097/01.AOG.0000465192.34779.dc
12. Joffres M, Jaramillo A, Dickinson J, Lewin G, Pottie K, Shaw E, et al. Recommendations on screening for depression in adults. CMAJ. 2013 Jun;185(9):775-82. doi: http://dx.doi.org/10.1503/cmaj.130403
13. Mitchell J, Trangle M, Degnan B, Gabert T, Haight B, Kessler D, et al. Adult Depression in Primary Care. Bloomington: Institute for Clinical Systems Improvement; 2013. 129 p.
14. Siu AL, Bibbins-Domingo K, Grossman DC, Baumann LC, Davidson KW, Ebell M, et al. Screening for Depression in Adults US Preventive Services Task Force Recommendation Statemen. JAMA. 2016 Jan;315(4):380-7. doi: http://dx.doi.org/10.1001/jama.2015.18392
15. Olariu E, Forero CG, Castro-Rodriguez JI, Rodrigo-Calvo MT, Álvarez P, Martín-López LM, et al. Detection of anxiety disorders in primary care: a meta-analysis of assisted and unassisted diagnoses. Depress Anxiety. 2015 Jul;32(7):471-84. doi: http://dx.doi.org/10.1002/da.22360
16. Depression [Elektronnyi resurs]: inform biul. V: Vsemirnaia organizatsiia zdravookhraneniia: [sait]. Vashington, USA; 2020. Rezhim dostupa: https://www.who.int/ru/news-room/fact-sheets/detail/depression. Data dostupa: 26.10.2020. (In Russ.)
17. O’Connor EA, Whitlock EP, Gaynes B, Beil TL. Screening for Depression in Adults and Older Adults in Primary Care: An Updated Systematic Review: Evidence Synthesis No. 75. Rockville: Agency for Healthcare Research and Quality; 2009. 167 p.
18. Center for Drug Evaluation and Research, US Food and Drug Administration. Clinical review: relationship between antidepressant drugs and suicidality in adults. Available from: https://www.baumhedlundlaw.com/documents/pdf/dolin-trial-exhibits/jx-13-clinical-review-relationship-between-antidepressant-drugs-and-suicidality-in-adults.pdf. [Accessed 26th Oct 2020]
19. Dalton SO, Sorensen HT, Johansen C. SSRIs and upper gastrointestinal bleeding: what is known and how should it influence prescribing? CNS Drugs. 2006;20(2):143-51. doi: http://dx.doi.org/10.2165/00023210-200620020-00005
20. Gurov VA, Medvedev VE. Anxiety disorders in general practice: clinical and therapeutic aspects. Arkh Vnutr Meditsiny. 2011;(2):15-9. (In Russ.)
21. Pogosova NV, Dovzhenko TV, Babin AG, Kursakov AA, Vygodin VA. Russian-language versions of the PHQ-2 and 9 questionnaires: sensitivity and specificity in detecting depression in patients of general medical outpatient practice. Kardiovaskuliar Terapiia Profilaktika. 2014;13(3):18-24. (In Russ.)
22. On the approval of an indicative list of methods and techniques for the provision of psychological assistance, recommended for use in public health organizations: prikaz M-va zdravookhraneniia Resp Belarus’, 29 iiunia 2018 g, № 662. V: Baza NPA Ministerstva zdravookhraneniia Respubliki Belarus’ [Elektronnyi resurs]. Minsk, RB; 2020. Rezhim dostupa: http://minzdrav.gov.by/ru/dlya-spetsialistov/normativno-pravovaya-baza/baza-npa.php?ELEMENT_ID=328669. Data dostupa: 26.10.2020. (In Russ.)
23. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. doi: http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x
24. Andriushenko AV, Drobizhev MIu, Dobrovol’skii AV. Comparative assessment of the CES-D, BDI and HADS scales (d) in the diagnosis of depression in general medical practice. Zhurn Nevrologii Psikhiatrii im SS Korsakova. 2003;103(5):11-8. (In Russ.)
25. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002 Feb;52(2):69-77. doi: http://dx.doi.org/10.1016/s0022-3999(01)00296-3
26. Assanovich MA. The problem of scientific measurement in psychodiagnostics. Zhurn GrGMU. 2014;(1):9-13. (In Russ.)
27. On the approval of the instructions on the procedure for conducting medical examination: postanovlenie M-va zdravookhraneniia Resp Belarus’, 12 avg 2016 g, № 96. V: Ministerstvo zdravookhraneniia Respubliki Belarus’ [Elektronnyi resurs]: [sait]. Minsk, RB; 2020. Rezhim dostupa: http://minzdrav.gov.by/ru/dlya-belorusskikh-grazhdan/dispanserizatsiya.php. Data dostupa: 26.10.2020. (In Russ.)
28. Remes O, Brayne C, van der Linde R, Lafortune L. A systematic review of reviews on the prevalence of anxiety disorders in adult populations. Brain Behav. 2016 Jun;6(7):e00497. doi: http://dx.doi.org/10.1002/brb3.497
29. Serrano-Blanco A, Palao DJ, Luciano JV, Pinto-Meza A, Luján L, Fernández A, et al. Prevalence of mental disorders in primary care: results from the diagnosis and treatment of mental disorders in primary care study (DASMAP). Soc Psychiat Epidemiol. 2010 Feb;45(2):201-10. doi: http://dx.doi.org/10.1007/s00127-009-0056-y
30. Toft T, Fink P, Oernboel E, Christensen K, Frostholm L, Olesen F. Mental disorders in primary care: prevalence and comorbidity among disorders. Results from the functional illness in primary care (FIP) study. Psychol Med. 2005 Aug;35(8):1175-84. doi: http://dx.doi.org/10.1017/s0033291705004459

Information about authors:
Kirpichenka A.A. – Doctor of Medical Sciences, associate professor, head of the Chair of Psychiatry & Narcology, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0003-4861-2324;
Baryshau A.N. – lecturer of the General Practitioner Chair with the course of Outpatient Therapy, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210039, Vitebsk, 37-57 P. Brovki str. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Andrey A. Kirpichenka.

Поиск по сайту