The paper ‘Variables Associated with Emotional Symptom Severity in Primary Care Patients: The Usefulness of a Logistic Regression Equation to Help Clinical Assessment and Treatment Decisions’ by Ángel Aguilera-Martín, Mario Gálvez-Lara, Roger Muñoz-Navarro, César González-Blanch, Paloma Ruiz-Rodríguez, Antonio Cano-Videl and Juan Antonio Moriana, published in The Spanish Journal of Psychology, has been chosen as the Editor’s Choice Article for December 2023.

Have you ever gone to the Public Healthcare system for psychological therapy? Do you remember how long you had to wait between appointments? Mental health care is one of the services included in the Spanish public healthcare system, but an increase in demand —either due to the rise in cases of mental disorders, or due to the increasing awareness of these problems and the need to seek help—, combined with a lack of public investment, has caused that patients have to wait between several weeks and several months between appointments, which impairs the continuity of therapy and the recovery process.

This specialised service is accessed through referral by general practitioners (GPs), who have become the first line of detection and treatment for mental health problems, especially depression and anxiety. However, the limited training in Psychology that these professionals receive and the lack of time due to the huge patient load have led to the frequent use of medication, which, far from being a solution, can chronify the problem and create addiction. This is why in recent years professionals have been urging the inclusion of clinical psychologists in primary care and the promotion of prevention. However, in order to prevent, it is necessary to identify the factors that influence the development of depression and anxiety.

How we regulate our emotions is decisive

In order to contribute to research in this area, we used data from a large sample of primary care patients —that is, from outpatient centers— from different regions of Spain. These patients went to their GPs with complaints of typical symptoms of depression and anxiety. It was observed that, when faced with a problem, the way in which the person manages their emotions and thoughts influences whether they end up having anxiety-depressive symptoms or not. For example, people who “ruminate” a lot, that is, those who just keep going over things in their heads, are more likely to become depressed and have anxiety attacks. Also, those who worry too much, to the point of anticipating things that have not yet happened, tend to have higher levels of depression and anxiety. Moreover, in relation to the beliefs that patients had about their own thoughts —the so-called metacognitions—, the people who presented more severe symptoms were those who perceived their worries as dangerous to their health.

These results show that, although we are all exposed to the risk of suffering emotional problems, it is the strategies for regulating or managing those emotions and thoughts that can determine whether we end up suffering a disorder. In addition, as we explain in our article with an example, these factors related to mental health can be used in practice so that, through statistical calculations, they can help us to identify patients with severe symptoms of depression and anxiety more efficiently.

What can we expect?

We are confident that the results of our study, which has a fairly large and representative Spanish sample, will contribute to the knowledge of anxiety-depressive disorders and that this knowledge can be used to create prevention protocols to avoid mild emotional problems from turning into serious disorders, as well as to develop more effective psychological interventions that only require, in a few exceptions, complementary medication. We also believe that implementing these improvements directly in outpatient clinics would allow mental health problems to be tackled earlier and, in this way, miss the crash of waiting lists.

Finally, we encourage the reader to send us their comments to the email address indicated in the article.