Diagnosing Anxiety and Depression in the Primary Care Setting

Heidi Combs, MD, says that many patients present to the primary care office thinking that they have other health problems when the diagnosis is really anxiety or depression. She discussed the topic at the American College of Physicians Internal Medicine Meeting (ACP 2017) in San Diego, California.

Anxiety and depression are quite common, and primary care physicians are often the first to evaluate patients’ symptoms. However, Heidi Combs, MD, associate professor of psychiatry at the University of Washington, says that many patients present to the office thinking they have other health problems.

Combs gave a talk on this topic at the American College of Physicians Internal Medicine Meeting (ACP 2017) in San Diego, California. She explained to MD Magazine that many people don’t have access to a psychiatrist and feel comfortable with the primary care doctor they’ve built trust with.

When a patient comes in complaining of not being able to sleep, pain, or gastrointestinal issues, he or she could actually be experiencing depression or anxiety. “But they don’t realize that what they’re experiencing is depression or anxiety,” Combs explained, “what they experience are these somatic manifestations of their psychic distress.”

There are various effective screening tools for anxiety and depression, such as the GAD-2 or GAD-7. But Combs explained that sometimes the best thing to do is just ask them. “I have 5 screening questions that I ask that screen for the major anxiety disorders for patients,” she said. Watch the video above to hear those 5 questions and more on diagnosing anxiety and depression in the primary care setting.

>>> More Coverage from ACP 2017