RESUMO
OBJECTIVE: To analyse the diagnostic concordance index between primary care and mental health. DESIGN: Retrospective and descriptive study. SETTING: Mental health centre, Estella, Navarra, Spain. PARTICIPANTS. New consecutive adults patients referred to mental health (n=1005) from july 2002 to march 2005. MAIN MEASUREMENTS: Analysis of diagnoses made in primary care and mental health during the time period. Calculation of kappa index for inter-observer concordance. RESULTS: General diagnostic concordance had a kappa index =0.385 (+/-0.018). High concordance index (>0.7) was obtained for alcohol and other substance use disorders and psychotic disorders. Moderate concordance index (0.4-0.7) was obtained for eating disorders and organic mental disorders. However, low concordance index (<0.3) was obtained for anxiety, adaptative, and affective disorders. CONCLUSIONS: In general, diagnostic concordance between primary care and mental health is weak. Particularly noticeable was difficulty in identifying adaptative disorders adequately. There was a strong tendency in primary care to identify these disorders as anxiety or affective disorders.