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	Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In Vol. 9 No. 9, September 2000   Archives  •  Online Features Original Contribution  This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (107)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Psychiatry  • Depression  • Panic Disorder  • Suicide  • Substance Abuse/ Alcoholism  • Alert me on articles by topic Prevalence of Anxiety, Depression, and Substance Use Disorders in an Urban General Medicine Practice Mark Olfson, MD, MPH; Steven Shea, MD; Adriana Feder, MD; Milton Fuentes, PsyD; Yoko Nomura, PhD; Marc Gameroff, MA; Myrna M. Weissman, PhD Arch Fam Med. 2000;9:876-883. Background  Most research on the prevalence of mental disorders in primary care has been conducted in practices that serve middle- and upper-income patients. Objective  To determine the prevalence of major mental disorders in a primary care practice that serves a predominantly low-income immigrant patient population. Design  Cross-sectional survey; criterion standard. Setting  Urban general medicine practice. Participants  Systematic sample of consecutive adult patients with scheduled appointments. Of 1266 approached eligible patients, 1007 (80%) participated. Main Outcome Measures  PRIME-MD Patient Health Questionnaire major depression, generalized anxiety disorder, panic disorder, alcohol use disorder, and suicidal ideation; drug use disorder; functional status; work loss; family distress; and mental health treatment. Results  Major depression (18.9%), generalized anxiety (14.8%), panic (8.3%), and substance use (7.9%) disorders and suicidal ideation (7.1%) were highly prevalent. Many patients had more than 1 disorder (range, 36.3% [substance use disorder] to 76.9% [panic disorder]). In multivariate analyses, each disorder was significantly associated with an increase in impairment after controlling for demographic characteristics, perceived health, and the other disorders. A minority of patients with each disorder (range, 22.5% [substance use disorder] to 46.4% [panic disorder]) reported receiving mental health treatment in the last month. Conclusions  Clinically significant depression, anxiety, substance use, and suicidal ideation are quite common in this practice and associated with significant functional impairment. Primary care practices that serve poor urban immigrant populations have a critical need to provide access to mental health services. From the Departments of Psychiatry and Medicine, College of Physicians and Surgeons of Columbia University, and New York State Psychiatric Institute, New York. 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