Detección de ansiedad y depresión en Atención Primaria: utilidad de 2 escalas breves adaptadas a los nuevos criterios CIE-11-AP

Abstract

Introduction

The World Health Organization has developed a new classification of mental disorders in Primary Health Care (PHC), the ICD-11-PHC, in which there are changes in the diagnostic criteria of anxiety and depression disorder. In addition, 2 screening instruments have been developed for the detection of anxious and depressive symptoms according to the criteria of the new classification.

Objectives

To evaluate the capacity of the Spanish version of the 2 brief scales Dep5 and Anx5 to identify cases of depression and anxiety in PHC in Spain.

Method

A cross-sectional study conducted by 37 PHC physicians who selected 284 patients with suspected emotional distress. This sample was administered the screening scales (Anx5 and Dep5) and a diagnostic instrument (Clinical Interview Schedule-Revised) contemplating the new ICD-11 criteria as used as gold standard.

Results

The Anx5, using a cut-off point of 3, showed a sensitivity of 0.75 and specificity of 0.53. Using a cut-off point of 4, the Dep5 showed a sensitivity of 0.48 and a specificity of 0.8. The 2 scales together, with a cut-off point of 3 for each, classified correctly 73,57% as cases or non-cases. The diagnosis most frequently observed was anxious depression.

Conclusions

The screening scales for anxious and depressive symptoms (Anx5 and Dep5) are simple and easy-to-use instruments for assessing anxious and depressive symptoms in PHC. The reliability and validity data of each of the scales separately are limited but the figures improve when they are used together.