Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care

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The World Health Organization collaborative study on "Psychological
Problems in General Health Care" investigated the form,
frequency, course and outcome of common psychological
problems in primary care settings at 15 international sites.
The research employed a two-stage case-finding procedure.
GHQ-12 was administered to 25916 adults who consulted
health-care services. The second-stage assessment (n = 5438)
consisted of the Composite international Diagnostic Interview
(CIDI), the Social Disability Schedule, and questionnaires.
Possible cases or borderline cases of mental disorder, and a
sample of known cases, were followed up at three months and
one year. Using standard diagnostic algorithms (ICD-10),
prevalence rates were calculated for current disorder
(one-month) and lifetime experience disorder. Well-defined
psychological problems are frequent in all the general
health-care settings examined (median 24.0%). Among the most
common were depression anxiety, alcohol misuse, somatoform
disorders, and neurasthenia. Nine per cent of patients
suffered from a "subthreshold condition" that did not meet
diagnostic criteria but had clinically significant symptoms
and functional impairment. The most common co-occurrence was
depression and anxiety. Comorbidity increases the likelihood
of recognition of mental disorders in general health care,
and the likelihood of receiving treatment.

Sartorius N, Ustun TB, Lecrubier Y, Wittchen HU

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