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. ISSN 0007-1250

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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
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions:	Faculty of 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
Date:	June 2011
Volume:	Vol.198
Number:	No.6
Page Range:	pp. 472-478
Identification Number:	10.1192/bjp.bp.110.085092
Status:	Peer Reviewed
Publication Status:	Published
Funder:	Medical Research Council (Great Britain) (MRC)
Grant number:	G106/1053 (MRC)
URI:	http://wrap.warwick.ac.uk/id/eprint/40056

Data sourced from Thomson Reuters' Web of Knowledge

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