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Outcome of anxiety and depressive disorders in primary care

Published online by Cambridge University Press:  03 January 2018

Clare Ronalds
University Department of General Practice, Rusholme Health Centre
Francis Creed*
University Department of Psychiatry, Manchester Royal Infirmary
Kit Stone
University Department of Psychiatry, Manchester Royal Infirmary
Sarah Webb
University Department of General Practice, Rusholme Health Centre
Barbara Tomenson
University Department of Psychiatry, Manchester Royal Infirmary
Professor Francis Creed, Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL



Factors related to the outcome of depression and anxiety in primary care are not fully understood.


Adult patients in general practice with depressive, anxiety or panic disorder (n=148; DSM–III–R criteria) were studied prospectively for six months to determine the factors most closely associated with outcome. The Psychiatric Assessment Schedule, Hamilton Depression Rating Scale, Clinical Anxiety Scale and Life Events and Difficulties Schedule interviews were performed at index consultations and repeated six months later. Variables associated with outcome were assessed by multiple regression analysis.


Good outcome was predicted by mild depression at initial assessment, high educational level, and being in employment. At follow-up the most important predictor of improvement was reduction in marked difficulties over the six months. Recognition and management by the GP was most frequent in patients with severe disorder; such patients were least likely to improve because of the severity of their depression and marked social difficulties.


This naturalistic study helps to provide a framework for further studies with more precisely defined groups of people with depression. An effective treatment strategy for people with marked depression and ongoing social difficulties is especially needed.

Copyright © 1997 The Royal College of Psychiatrists 

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