Articlegreen1993

Depression, anxiety, and social disability show synchrony of change in primary care patients.

Johan Ormel · Michael Von Korff · Wim van den Brink · Wayne J. Katon · Els I. Brilman · Albertine J. Oldehinkel

255 citations0/0 files storedAmerican Journal of Public Health

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Mental Health Treatment and Access Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Aging, Health, and Disability

Abstract

OBJECTIVES: The purposes of this study were to (1) characterize the social disability associated with the common psychiatric illnesses of primary care patients in terms of role dysfunction (self-care, family role, social role, occupational role) and (2) establish whether severity of psychiatric illness and disability level show synchrony of change. METHODS: A two-stage sample design was employed. In the first stage, 1994 consecutive attenders of 25 general practitioners were screened on psychiatric illness by their physicians and with the General Health Questionnaire. A stratified random sample (n = 285) with differing probabilities was selected for a second-stage interview. Patients with psychiatric symptoms were reinterviewed 1 and 3.5 years later (n = 143). RESULTS: (1) Disability level among patients was increased (moderately for depression, mildly for anxiety) and was associated with severity of psychiatric illness. (2) Most disability was found in occupational and social roles. (3) Change in severity of psychiatric illness was concordant with change in level of disability and was largely invariant across diagnosis (depression, anxiety, mixed anxiety/depression). At follow-up, disability among improved patients had returned to normal levels. CONCLUSIONS: Psychiatric illness in primary care patients is associated with mild to moderate disability, and severity of psychiatric illness and disability show synchrony of change.

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References

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1997The functioning and well-being of patients with unrecognized anxiety disorders and major depressive disorder 1997Treating Depressed Primary Care Patients Improves Their Physical, Mental, and Social Functioning 2017Social functioning in patients with depressive and anxiety disorders 1993Outcome of Depression and Anxiety in Primary Care 2002Longitudinal investigation of depression outcomes in primary care in six countries: the LIDO Study. Functional status, health service use and treatment of people with depressive symptoms

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