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Journal of the Korean Academy of Family Medicine 2005;26(11):699-705.
Published online November 10, 2005.
Prevalence of Mental Disorders in Family Practice Centers in Korea and the Utility of a Diagnostic Tool.
Young Sik Kim, Yeong Sook Yoon, Jeong Yeol Oh, Hee Tak Ryu, Dae Hyun Kim, Young Sung Suh, Byung Sung Kim, Yun Jin Kim, Sang Wook Song, Jungkwon Lee
1Department of Family Medicine, University of Ulsan College of Medicine, Korea.
2Department of Family Medicine, Inje University College of Medicine, Korea.
3Department of Family Medicine, Bundang Jesaeng General Hospital, Korea.
4Department of Family Medicine, Keimyung University College of Medicine, Korea.
5Department of Family Medicine, Kyung Hee University College of Medicine, Korea.
6Department of Family Medicine, Pusan National University College of Medicine, Korea.
7Department of Family Medicine, The Catholic University College of Medicine, Korea.
8Department of Family Medicine, Sungkyunkwan University School of Medicine, Korea. jkwonl@smc.samsung.co.kr
Abstract
Background
: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ).

Methods : Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ.

Results : The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P<0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49∼82) in major depressive disorders, 70% (50∼90) in panic disorders, 70% (56∼83) in somatoform disorders, 84% (75∼92) in alcohol abuse, and 68% (62∼74) in any mental disorders. Patients' response to the PHQ was overall very receptive.

Conclusion : One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.
Key Words: mental disorders, family practice, medical history taking, questionnaires, diagnosis


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