Diagnostic concordance between Primary Care and Mental Health

Abstract

Objetive. To analyse the diagnostic concordance index between Primary Care and Mental Health.

Methodology. Retrospective and descriptive study in Mental Health Centre of Villaverde, Madrid, Spain. The sample consists of 1050 consecutive new adult patients referred from Primary Care to Mental Health Center from January to December 2016. The following variables were recorded: Primary Health Center of origin, age, sex, type of activity requested in the referral (Psychiatry or Psychology), diagnosis established by Primary Care and diagnosis established by Mental Health.

Results. Diagnostic concordance between Primary Care and Mental Health presented a global kappa coefficient of 0.383 (CI 95% 0.333-0.433). The diagnostic groups with the lowest concordance were adaptive disorder (kappa: 0.200), anxiety disorder (kappa: 0.242) and depressive affective disorder (kappa: 0.340). The diagnostic groups with the highest concordance were bipolar disorder (kappa: 0.816) and psychotic disorder (kappa: 0.689). Adaptive disorder was the most frequently diagnostic in Mental Health among those who did not coincide with Primary Care (38.99%).

Conclusions. Diagnostic concordance between Primary Care and Mental Health is low, which could affect the quality of care offered to patients. New strategies are needed to increase this diagnostic concordance.