Mental health problems in Norwegian general practice : Identification, presentation, and diagnosis

Abstract

Mental health disorders are prevalent, exerting a significant demand on patients, health care systems, and society. Studies find that these disorders often remain undiagnosed by general practitioners in primary care. This thesis explores the prevalence of mental health diagnoses in general practice, their association with somatic symptom diagnoses, and the correlation between general practitioners’ diagnoses and patient-reported mental distress. This was conducted through cross-sectional analyses of a complete cohort of patients’ electronic medical records for 12 months, combined with a questionnaire study with patients. Nearly one in five patients had received a mental health diagnosis, and these patients had a significant increase in consultations, regardless of the reason for contact. Depression, anxiety, acute stress reaction and sleep disorder were the most common diagnoses. Patients with common mental health diagnoses had a significant increase in the number of somatic symptom diagnoses during the 12 months. We found similar somatic symptoms associated with having a mental health disorder with small variations. We found a clear association between the level of patient-reported mental distress and the probability of having received a mental health diagnosis. The probability of a diagnosis increased with increasing levels of mental distress and an increasing number of consultations. Still, only three in four patients with high levels of mental distress had received a mental health diagnosis. In conclusion, patients diagnosed with mental health disorders report higher mental distress, have more frequent consultations, and increased somatic symptoms. Improved comprehension of mental health identification and diagnosis in primary care is crucial to provide better outcomes in the future.