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The burden of mental disorders in primary care

Published online by Cambridge University Press:  16 April 2020

G. Grandes*
Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, Luis Power, 18-4a Planta, 48014Bilbao, Spain
I. Montoya
Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, Luis Power, 18-4a Planta, 48014Bilbao, Spain
M.S. Arietaleanizbeaskoa
Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, Luis Power, 18-4a Planta, 48014Bilbao, Spain
V. Arce
Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, Luis Power, 18-4a Planta, 48014Bilbao, Spain
A. Sanchez
Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, Luis Power, 18-4a Planta, 48014Bilbao, Spain
on behalf of the MAS group
Primary Care Research Unit of Bizkaia, Basque Healthcare Service - Osakidetza, Luis Power, 18-4a Planta, 48014Bilbao, Spain
Corresponding author. Tel.: +34 94 600 66 38; fax: +34 94 600 66 39. E-mail address: (G. Grandes).
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To describe and compare the prevalence of mental disorders across primary care populations, and estimate their impact on quality of life.


Cross-sectional multilevel analysis of a systematic sample of 2539 attendees to eight primary care centres in different regions of Spain, assessed with the WHO Composite International Diagnostic Interview (CIDI 1.1), the Short Form Health Survey (SF-36) quality of life questionnaire and the SF-6D utility index.


The 12-month prevalence of any mental disorder was 23% (95% confidence interval: 21–24%), 10% had mood, 9% anxiety, 5% organic, 4% somatoform, and 1% alcohol use disorders, with a significant between-centre variability (P < 0.001). People with mental disorders had one standard deviation lower mental quality of life than the general population. We estimated that 1831 quality-adjusted life-years (QALYs) are lost annually per 100,000 patients due to mental disorders, without considering mortality. Mood disorders have the worst impact with an annual loss of 1124 QALYs per 100,000 patients, excluding mortality (95% confidence interval: 912–1351).


Prevalence rates were similar to those obtained in international studies using the same diagnostic instrument and, given the significant between-centre variability found, it is recommended that mental health statistics be considered at small area level. Mental disorders, and especially mood disorders, are associated with very poor quality of life and higher scores on disability indexes than other common chronic conditions.

Original article
Copyright © European Psychiatric Association 2010

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Director team: Primary Care Research Unit of Bizkaia, Basque Healthcare Service-Osakidetza (principal investigator: Gonzalo Grandes; co-investigators: Alvaro Sanchez, Imanol Montoya, Ricardo Ortega Sanchez-Pinilla). Research team: Basque Healthcare Service-Osakidetza: Basauri-Aríz Health Center (Jesús Torcal,Verónica Arce), Galdakao Health Center (Pilar Echevarria, Marisol Arietaleanizbeaskoa), Algorta Health Center (Irene Toquero, Janire Payo). Catalonian Healthcare Service: Serraparera Health Center, Barcelona (Agusti Guiu, Ana Cascos). Castilla y León Healthcare Service: Casa Barco Health Center, Valladolid (Carmen Fernández, Jose Ignacio Recio), La Alamedilla Health Center, Salamanca (Luis García, Manuel Gómez, Yolanda Castaño). Castilla – la Mancha Healthcare Service: San Fernando Cuenca III Health Center, Cuenca (Vicente Martinez, Patricia López). Galicia Health Service: Sardoma Health Center, Vigo (Francisco J Soidán, Marisa Enríquez).


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