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.
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.
Authors: Adam Wa Geraghty; Miriam Santer; Samantha Williams; Jennifer Mc Sharry; Paul Little; Ricardo F Muñoz; Tony Kendrick; Michael Moore Journal: Health (London) Date: 2016-10-01
Authors: Antonio Cano-Vindel; Roger Muñoz-Navarro; Cristina Mae Wood; Joaquín T Limonero; Leonardo Adrián Medrano; Paloma Ruiz-Rodríguez; Irene Gracia-Gracia; Esperanza Dongil-Collado; Iciar Iruarrizaga; Fernando Chacón; Francisco Santolaya Journal: JMIR Res Protoc Date: 2016-12-23
Authors: Hanno Hoven; Morten Wahrendorf; Marcel Goldberg; Marie Zins; Johannes Siegrist Journal: Eur J Public Health Date: 2021-12-01 Impact factor: 3.367