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Mixed anxiety and depressive disorder outcomes : prospective cohort study in primary care
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Walters, K., Buszewicz, M., Weich, Scott and King, Michael B. (2011) Mixed anxiety and depressive disorder outcomes : prospective cohort study in primary care. The British Journal of Psychiatry, Vol.198 (No.6). pp. 472-478. doi:10.1192/bjp.bp.110.085092 ISSN 0007-1250.
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Official URL: http://dx.doi.org/10.1192/bjp.bp.110.085092
Abstract
Background:
Mixed anxiety and depressive disorder (MADD) is common yet ill-defined, with little known about outcomes.
Aims:
To determine MADD outcomes over 1 year.
Method:
We recruited 250 adults attending seven London general practices with mild moderate distress. Three groups were defined using a diagnostic interview: MADD, other ICD-10 psychiatric diagnosis, no psychiatric diagnosis. We assessed symptoms of distress (General Health Questionnaire-28), quality of life (12-item Short Form Health Survey), general practitioner (GP) diagnosis and consultation rate at baseline, 3 months and 1 year.
Results
Two-thirds of participants with MADD had no significant psychological distress at 3 months (61%) or 1 year (69%). However, compared with those with no diagnosis, individuals had twice the risk of significant distress (incidence rate ratio 2.39, 95% CI 1.29-4.42) at 3 months but not 1 year, and persistently lower quality of life (mental health functioning). There was no significant difference in GP consultation rate/diagnosis.
Conclusions:
The majority with MADD improved, but individuals had an increased risk of significant distress at 3 months and a lower quality of life. As we cannot currently predict those with a poorer prognosis these patients should be actively monitored in primary care.
Item Type: | Journal Article | ||||
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Subjects: | B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||
Library of Congress Subject Headings (LCSH): | Anxiety, Depression, Mental, Cohort analysis, Primary care (Medicine) | ||||
Journal or Publication Title: | The British Journal of Psychiatry | ||||
Publisher: | Royal College of Psychiatrists | ||||
ISSN: | 0007-1250 | ||||
Official Date: | June 2011 | ||||
Dates: |
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Volume: | Vol.198 | ||||
Number: | No.6 | ||||
Page Range: | pp. 472-478 | ||||
DOI: | 10.1192/bjp.bp.110.085092 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Funder: | Medical Research Council (Great Britain) (MRC) | ||||
Grant number: | G106/1053 (MRC) |
Data sourced from Thomson Reuters' Web of Knowledge
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