Anxiety and depression in primary care patients: Predictors of symptom severity and developmental correlates

Abstract Background: To improve the quality of health care provided to primary care patients with mental disorders, it is crucial to understand more about the mental symptoms that underlie diagnoses on sick leave certificates. This study therefore aimed to: 1) investigate whether diagnoses on sick leave certificates corresponded to the results of a structured psychiatric interview and to self-rated symptom severity and 2) investigate the association between length of sick leave and the diagnoses on sick leave certificates, the diagnoses made in structured psychiatric interviews, and self-rated symptom severity. Methods: The study used data from 480 patients in SAFARI, a study on sick leave in patients with common mental disorders. At baseline, background variables were gathered and structured psychiatric interviews (M.I.N.I.) were performed. Severity of depression and adjustment disorder was assessed via self-rating scales. Data on sick leave were gathered at baseline and at 12 months from the Swedish Social Insurance Agency and patients’ medical records. Results: The diagnostic criteria for depression were fulfilled by a total of 76% of patients with a sick-leave diagnosis of adjustment disorder, 67% with a sick-leave diagnosis of anxiety, and 65% with a sick-leave diagnosis of depression (p=0.04). There was no significant difference in mean net sick leave days between those with a sick-leave certificate diagnosis of adjustment disorder (mean days 119.9), anxiety disorder (107.2), or depression (137.1). However, those with depression diagnosed via structured interview had a shorter mean net sick leave (112.3) than those who did not fulfil the depression criteria (155.9). Symptom severity was strongly associated with net sick leave days; those who rated their depression or adjustment disorder symptoms as more severe had longer net sick leave. Conclusions: Many patients with sick-leave certificate diagnoses of adjustment and anxiety disorders have ongoing depression. Longer sick leave duration was observed in those with adjustment disorder and more severe self-reported symptoms, both of which are appropriate according to Swedish guidelines.

Download Full-text

Anxiety and depression in primary care patients suffering of rheumatoid diseases

Psychiatriki ◽

10.22365/jpsych.2020.312.140 ◽

2020 ◽

Vol 31 (2) ◽

pp. 140-150

Author(s):

A. Zartaloudi ◽

I. Koutelekos ◽

M. Polikandrioti ◽

S. Stefanidou ◽

D. Koukoularis ◽

...

Keyword(s):

Primary Care ◽

Anxiety And Depression ◽

Primary Care Patients ◽

Rheumatoid Diseases

Download Full-text

The Relationship Between Social Dysfunctioning and Psychopathology among Primary Care Attenders

The British Journal of Psychiatry ◽

10.1192/bjp.163.1.37 ◽

1993 ◽

Vol 163 (1) ◽

pp. 37-44 ◽

Cited By ~ 26

Author(s):

Tamar D. Wohlfarth ◽

Wim Van Den Brink ◽

Johan Ormel ◽

Maarten W. J. Koeter ◽

Albertine J. Oldehinkel

Keyword(s):

Primary Care ◽

Psychological Disorder ◽

Anxiety And Depression ◽

Future Research ◽

Physical Disorders ◽

Primary Care Patients ◽

The One ◽

The Relationship ◽

Temporal Sequences

The extent of social dysfunctioning and its relationship to psychological disorders among Dutch primary care patients was examined. Social dysfunctioning in these patients was rather limited, but was more pronounced in patients with a psychological disorder than in those without. Disabilities were largely restricted to the occupational and social roles, with family role functioning and self-care relatively intact. Social dysfunctioning was moderately related to psychopathology, with higher levels of dysfunctioning in more severe and depressed cases. The extent of social dysfunctioning among patients with both anxiety and depression was similar to that of patients with a single diagnosis of depression. Depressed patients had a similar level of dysfunctioning to non-psychotic psychiatric out-patients. Analyses regarding the effects of diagnosis and severity on social dysfunctioning revealed considerable overlap between these two aspects of psychopathology. This study supports the need for a simultaneous but separate assessment of psychopathology and social dysfunctioning. However, future research should incorporate additional predictors of social dysfunctioning (e.g. personality, life events, long-term difficulties, physical disorders), and prospective studies should be conducted to clarify the temporal sequences of symptom severity, diagnosis, and comorbidity on the one hand, and social dysfunctioning on the other.

Download Full-text

Association of blood pressure with anxiety and depression in a sample of primary care patients

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.614 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s496-s496 ◽

Cited By ~ 1

Author(s):

A. Sacchetti ◽

G. Mattei ◽

S. Bursi ◽

M.S. Padula ◽

G. Rioli ◽

...

Keyword(s):

Blood Pressure ◽

Primary Care ◽

High Body Mass Index ◽

Hereditary Disease ◽

Two Dimensions ◽

Anxiety And Depression ◽

Depression Symptoms ◽

Inverse Association ◽

Cross Sectional ◽

Primary Care Patients

IntroductionAccording to international scientific literature, and as summarized in the guidelines of the International Society of Hypertension, lowering of blood pressure can prevent cardiovascular accidents. Some studies suggest that hypertension, anxiety, and depression might be inversely correlated.ObjectiveTo investigate whether blood pressure is associated with anxiety and depression.MethodsCross-sectional design. Male and female primary care patients were enrolled, aged 40–80. Criteria of exclusion adopted: use of antidepressants or antipsychotics; previous major cardiovascular event; psychosis or major depression; Type 1-DM; pregnancy and hereditary disease associated to obesity. Anxiety and depression symptoms were assessed using HADS. Waist circumference, hip circumference, blood pressure, HDL, triglycerides, blood sugar, hypertension, albumin concentrations and serum iron were also assessed.ResultsOf the 210 subjects, 84 were men (40%), mean age was 60.88 (SD ± 10.88). Hypertension was found to correlate significantly to anxiety (OR = 0.38; 95% CI = 0.17–0.84), older age (OR = 3.96; 95% CI = 1.88–8.32), cigarette smoking (OR = 0.35; 95%CI = 0.13–0.94), high Body Mass Index (OR = 2.50; 95% CI = 1.24–5.01), Waist-hip ratio (OR = 0.09; 95% CI = 0.02–0.46) and the Index of comorbidity (OR = 16.93; 95% CI = 3.71–77.29).ConclusionsAn inverse association was found between anxiety and hypertension, suggesting the need to clinically manage these two dimensions in a coordinated way. Other findings are well known and already included in prevention campaigns. Further research is needed, also to better understand and explain the causative pathways of this correlation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text