Select Journal or Resource JAMA & Archives Home JAMA Archives of   Dermatology   Facial Plastic Surgery   Family Medicine (1992-2000)   General Psychiatry   Internal Medicine   Neurology   Neurology and Psychiatry (1919-1959)   Ophthalmology   Otolaryngology—Head & Neck Surgery   Pediatrics & Adolescent Medicine   Surgery JAMA-français JAMA & Archives CME Calendar of Events JAMA Career Center For The Media JAMAevidence Peer Review Congress Student JAMA (1998-2004)

	Institution: CLOCKSS  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 4 No. 10, October 1995   Archives  •  Online Features Original Contributions  This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal Prevalence of Mental Disorders in Primary Care Implications for Screening Andrew C. Leon, PhD; Mark Olfson, MD; W. Eugene Broadhead, MD, PhD; James E. Barrett, MD; Robert S. Blacklow, MD; Martin B. Keller, MD; Edmund S. Higgins, MD; Myrna M. Weissman, PhD Arch Fam Med. 1995;4(10):857-861. Abstract Objectives To determine the prevalence of five mental disorders in primary care and to identify patient groups that have a relatively high prevalence of these disorders. Design Two-stage case identification design that involves administration of a 16-item screening instrument followed by an independent diagnostic assessment. Setting Three family practice offices in Rhode Island. Subjects A total of 937 primary care patients completed the brief screen, 388 of whom completed the independent diagnostic assessment. Prevalence Estimation A Bayesian procedure was used to estimate prevalence of mental disorder from screening and assessment results. Independent assessments were based on the Structured Clinical Interview for DSM-III-R administered by a mental health professional. Results The prevalence estimates were alcohol abuse or dependence, 3.2%; generalized anxiety disorder, 2.8%; major depressive disorder, 14.1%; obsessive-compulsive disorder, 2.2%; panic disorder, 6.2%; and any of the five disorders, 22.0%. The prevalence of any of the five disorders was higher in patients returning for follow-up visits (27.9%) than in those either presenting with a new illness (21.7%) or seeking a routine physical examination (11.8%). The combined prevalence was also higher in patients with a chronic medical problem (25.8%) than in those without (16.7%). Conclusions Patients returning for follow-up care and, to a lesser extent, those with chronic medical problems appear to be at increased risk of having a mental disorder. The practice of selectively screening new patients for mental health problems is questioned. Screening efforts in primary care should include established patients and those with chronic medical illnesses as well as new patients. Author Affiliations From Cornell University Medical College, New York, NY (Dr Leon); College of Physicians and Surgeons of Columbia University and New York State Psychiatric Institute, New York (Drs Olfson and Weissman); Duke University Medical Center, Durham, NC, and Ambulatory Services of Danville (Va) (Dr Broadhead); Dartmouth Medical School, Hanover, NH (Dr Barrett); Northeastern Ohio Universities College of Medicine, Rootstown (Dr Blacklow); Brown University School of Medicine, Providence, RI (Dr Keller); and the Medical University of South Carolina, Charleston (Dr Higgins). Drs Leon, Olfson, Barrett, Blacklow, Keller, Higgins, and Weissman have served as consultants to The Upjohn Company, Kalamazoo, Mich. THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES Brief Intervention for Anxiety in Primary Care Patients Roy-Byrne et al. J Am Board Fam Med 2009;22:175-186. ABSTRACT | FULL TEXT   Association of Depression and Anxiety Alone and in Combination With Chronic Musculoskeletal Pain in Primary Care Patients Bair et al. Psychosom. Med. 2008;70:890-897. ABSTRACT | FULL TEXT   How Older Adults Combine Medical and Experiential Notions of Depression Wittink et al. Qual Health Res 2008;18:1174-1183. ABSTRACT   Equity in Veterans' Mental Health Care: Veterans Affairs Medical Center Clinics Versus Community-Based Outpatient Clinics Kirchner et al. American Journal of Medical Quality 2008;23:128-135. ABSTRACT   Anxiety Disorders in Primary Care: Prevalence, Impairment, Comorbidity, and Detection Kroenke et al. ANN INTERN MED 2007;146:317-325. ABSTRACT | FULL TEXT   A mixed-methods approach to understanding loneliness and depression in older adults. Barg et al. Journals of Gerontology Series B: Psychological Sciences and Social Science 2006;61:S329-S339. ABSTRACT | FULL TEXT   Clinical practice. Panic disorder. Katon NEJM 2006;354:2360-2367. FULL TEXT   A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Spitzer et al. Arch Intern Med 2006;166:1092-1097. ABSTRACT | FULL TEXT   A Randomized Trial to Improve the Quality of Treatment for Panic and Generalized Anxiety Disorders in Primary Care Rollman et al. Arch Gen Psychiatry 2005;62:1332-1341. ABSTRACT | FULL TEXT   Screening for common mental disorders: who will benefit? Results from a randomised clinical trial Christensen et al. Fam Pract 2005;22:428-434. ABSTRACT | FULL TEXT   Screening for Bipolar Disorder in a Primary Care Practice Das et al. JAMA 2005;293:956-963. ABSTRACT | FULL TEXT   Major Depression, Physical Illness, and Suicidal Ideation in Primary Care Goodwin et al. Psychosom. Med. 2003;65:501-505. ABSTRACT | FULL TEXT   Nationwide Longitudinal Study of Psychological Responses to September 11 Silver et al. JAMA 2002;288:1235-1244. ABSTRACT | FULL TEXT   Psychological Disorders and Distress in Older Primary Care Patients: A Comparison of Older and Younger Samples Klapow et al. Psychosom. Med. 2002;64:635-643. ABSTRACT | FULL TEXT   The Prevalence of Clinically Recognized Obsessive-Compulsive Disorder in a Large Health Maintenance Organization Fireman et al. Am. J. Psychiatry 2001;158:1904-1910. ABSTRACT | FULL TEXT   The Cost-Utility of Screening for Depression in Primary Care Valenstein et al. ANN INTERN MED 2001;134:345-360. ABSTRACT | FULL TEXT   Traumatic Life Events in Primary Care Patients: A Study in an Ethnically Diverse Sample Holman et al. Arch Fam Med 2000;9:802-810. ABSTRACT | FULL TEXT   Prevalence of Anxiety, Depression, and Substance Use Disorders in an Urban General Medicine Practice Olfson et al. Arch Fam Med 2000;9:876-883. ABSTRACT | FULL TEXT   PATIENTS WITH CHRONIC ALCOHOL ABUSE IN DUTCH FAMILY PRACTICES Lamberts and Okkes Alcohol Alcohol 1999;34:337-345. ABSTRACT | FULL TEXT   Development of a Brief Diagnostic Screen for Panic Disorder in Primary Care Stein et al. Psychosom. Med. 1999;61:359-364. ABSTRACT | FULL TEXT   Mental Disorders and Disability Among Patients in a Primary Care Group Practice Olfson et al. Am. J. Psychiatry 1997;154:1734-1740. ABSTRACT | FULL TEXT   Developing a Strategy for Managing Behavioral Health Care Within the Context of Primary Care Fisher and Ransom Arch Fam Med 1997;6:324-333. ABSTRACT   Prevalence of Mental Disorders in Primary Care JWatch Psychiatry 1995;1995:3-3. FULL TEXT   HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP   © 1995 American Medical Association. All Rights Reserved.