Health-related quality of life in primary care patients with recognized and unrecognized mood and anxiety disorders

Alvah R. Cass, Robert J. Volk, Donald E. Nease

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Objective: Primary care providers have been criticized for underrecognizing and undertreating mental health disorders. This criticism assumes patients with recognized disorders and those with unrecognized disorders suffer the same burden of illness. This study describes differences in health-related quality of life (HRQOL) in patients with recognized and unrecognized mood and anxiety disorders in a primary care setting. Methods: A probability sample of 500 adult ambulatory patients from a university-based, family practice clinic, completed the PRIME-MD mood and anxiety disorder modules and the SF-36 Health Survey. Computerized patient records were reviewed retrospectively to determine recognition of mood and anxiety disorders. The Mental Health (MCS) and Physical Health (PCS) Component Summary scales of the SF-36 served as the primary outcome measures. Results: Sub-threshold mood and anxiety disorders were less likely to be recognized by physicians than disorders meeting DSM-III-R criteria. Recognized mood disorders were associated with a significant decrement in MCS scores (poorer HRQOL) compared with unrecognized disorders. In contrast, recognized mood disorders demonstrated slightly higher PCS scores. Recognized and unrecognized mood disorders differed significantly in physical functioning, vitality, social functioning, role functioning related to emotional state, and mental health. Recognition of anxiety disorders was not related to HRQOL. Conclusions: Patients with mental health disorders that have been recognized by their health providers appear to suffer from poorer HRQOL than patients whose disorders have not been recognized. This relationship, though, is only apparent for mood disorders. Poorer physical functioning may mask less severe emotional symptoms in mood disorders; profound emotional symptoms make recognition easier.

Original languageEnglish (US)
Pages (from-to)293-309
Number of pages17
JournalInternational Journal of Psychiatry in Medicine
Volume29
Issue number3
StatePublished - 1999

Fingerprint

Anxiety Disorders
Mood Disorders
Primary Health Care
Quality of Life
Mental Health
Mental Disorders
Sampling Studies
Cost of Illness
Family Practice
Health
Masks
Health Surveys
Diagnostic and Statistical Manual of Mental Disorders
Outcome Assessment (Health Care)
Physicians

Keywords

  • Anxiety disorders
  • Depression
  • Health status
  • Mental health
  • Primary health care
  • Quality of life

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Health-related quality of life in primary care patients with recognized and unrecognized mood and anxiety disorders. / Cass, Alvah R.; Volk, Robert J.; Nease, Donald E.

In: International Journal of Psychiatry in Medicine, Vol. 29, No. 3, 1999, p. 293-309.

Research output: Contribution to journalArticle

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