Problem recognition and treatment recommendations of somatic and cognitive-affective presentations of depression and generalized anxiety

Abstract

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) are among the leading causes of disability in the world; yet, rates of treatment seeking are exceptionally low. Poor mental health literacy is an important barrier to treatment seeking. One component of mental health literacy that impedes help seeking is poor problem recognition, or misidentifying a disorder and its symptoms when they are present. Although a wealth of research has established that accuracy of problem recognition is associated with help seeking related constructs (e.g., types of treatments recommended, intentions to seek treatment), no study to date has examined problem recognition of MDD or GAD across varying symptom presentations. The current study aimed to examine rates of problem recognition of MDD and GAD across predominantly somatic and cognitiveaffective presentations. To address the study aims, N = 299 participants were recruited using TurkPrime. N = 292 participants were randomly assigned to either the cognitive affective condition in which they were presented with case-study vignettes of MDD and GAD with predominantly cognitive-affective presentations, or the somatic condition in which they were presented with case-study vignettes of MDD and GAD with predominantly somatic presentations. Participants’ problem recognition and treatment recommendations were assessed following each vignette. We found significant main effects of disorder (i.e., MDD, GAD) and presentation (i.e., somatic, cognitive-affective) on problem recognition, such that MDD was associated with higher recognition than GAD, and cognitive-affective presentations were associated with higher recognition than somatic presentations. A large effect of disorder, and a small effect of presentation were observed. The interaction effect of disorder and presentation on problem recognition was non-significant. Further, problem recognition was associated with treatment recommendations. However, disorder and presentation were not related to treatment recommendations. We also found a significant difference in treatment recommendations made for self and others. Findings from the current study fill a gap in the literature by providing an initial understanding of mental health literacy across symptom presentations. This is likely to aid in the further development of mental health literacy programs. Clinically, these findings also have the potential to help avoid misdiagnoses and the diagnostic delays associated with somatic presentations of MDD and GAD.