Mental Health Conditions Common in Primary Care Settings: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in Nature Mental Health that examined how many primary care encounters are devoted to mental health conditions.

The study

Using the Norwegian Population Register, investigators extracted all codes associated with patient encounters over a 14-year period (2006-2019) for individuals aged 0 to 100 years. In addition to quantifying the volume of encounters related to mental health conditions, researchers compared the number of these encounters to those for medical conditions in 15 different body systems (eg, skin, digestive, eye, and cardiovascular) as well as for encounters for body-wide infections, pain, and injuries.

The study included a total of 4 875 722 individuals registered with a primary care physician who generated 354 516 291 primary care encounters.

The findings

Nearly half (47%, n=2 309 787) of the over 4 million individuals with a PCP presented to primary care for a mental health condition.

Of all the primary care encounters, 11.7% (n=41 616 704) involved a mental health condition. Mental health encounters were not just comprised of the most common mental health disorders. Investigators noted that while about one-third of mental-health encounters involved depression (23.8%) or anxiety (14.1%), the rest included “diverse and complex mental-health complaints, symptoms and disorders” such as sleep disturbances (12.1%), substance abuse (8.3%), and psychosis (6.9%).

When researchers compared mental-health encounters with encounters for other medical conditions, they found that the musculoskeletal system was the only body system that accounted for a greater share of PCPs’ attention (17.4%).

Authors' comment

“The large volume of primary-care encounters devoted to diverse mental-health conditions underscores the need for physician training in mental health, for integrated mental-health services and for workforce capacity planning. PCPs may have a more important role in preventing the escalation of mental-health problems than heretofore appreciated.”

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