In , the proportion of responders scoring above threshold in 1987 and 2001 are compared.
Prevalence of mental problems according to the General Health Questionnaire in relation to sociodemographic characteristics in the first and second Dutch National Survey of General Practice.
Mental health, as indicated by the GHQ, was worse in 2001 than in 1987 (t = −8.14; P<0.001). When the cut-off point is laid between 1 and 2, 16.8% (95% confidence interval [CI] = 16.1% to 17.5%) of the responders score above threshold in 1987, while this figure was 22.8% (95% CI = 22% to 23.6%) in 2001. The increase in the percentage of persons scoring above GHQ cut-off score can be observed in all sociodemographic categories.
In both years, the odds of a higher GHQ are lower in men, in older people (>45 years), and among married people. These relationships have not changed between the two studies, but a change can be observed where the effect of education is concerned. In the first study, people with the highest level of education (college and/or university level) were more at risk of an above-threshold GHQ score than those with secondary education. In the second study, people with the lowest level of education were more at risk than people with the highest level.
Social problems in relation to patient characteristics in 1987 and 2001 are presented in .
Prevalence of social problems in the first and second Dutch National Survey of General Practice.
Family problems were reported by 6.1% of responders in 1987 and 7.9% in 2001, representing a significant increase over time (t = −4.1; P<0.001). The report of problems in relationships with other people also increased significantly, rising from 13.9% to 15.8% (t = −2.96; P<0.005). Problems with work were reported with comparable frequency (6.5% and 6.2% respectively), while the report of material problems decreased between 1987 and 2001 from 12.8% to 10.1% (t = 5.12; P<0.001).
In general, women, younger people, those with less education, divorcees and widows/widowers ran higher risks of having social problems, with some exceptions: men reported more problems regarding work, and older and higher educated persons reported more family problems in 1987 than in 2001.
The associations between sociodemographic characteristics and the report of social problems remained the same in 2001 as they were in 1987 except the following: in 1987, those with a higher educational background were at significantly more risk of having family problems, but in 2001 those with only basic education were more at risk; differences between men and women regarding work problems in 1987 (more men reporting them) had disappeared in 2001.
GPs’ diagnoses of psychological and social morbidity in 1987 and 2001 and their connection with patients’ mental and psychosocial health are given in .
Patients with a psychological diagnosis in relation to sociodemographic characteristics and mental health as measured by the General Health Questionnaire.
Contrary to self-rated mental health, as assessed using the GHQ, the prevalence of psychological diagnoses made by GPs decreased between 1987 and 2001 (t = 8.848; P<0.001). In cases of high GHQs, GPs made a psychological diagnosis 18% of the time in 1987 and 9% of the time in 2001.
The risks for several sub-categories of patients hardly changed at all, however. GHQ score remained the strongest predictor, although its predictive power had diminished (odds decreased from 4.22 to 2.94). In both periods, the odds for women, elderly and widowed patients were higher than those for men, younger and married patients. The odds for people with less education (compared with people with a university background) and for divorced people were still higher in 2001, but were no longer significant.
The prevalence of social diagnoses made by the GP has decreased (t = 3.617; P<0.001). In both periods, GHQ score and having family problems were the strongest predictors. Being divorced or having work problems, which were significant factors in 1987, were no longer statistically significant in the second study.