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Mixed anxiety and depressive disorder outcomes: prospective cohort study in primary care

  • Kate Walters (a1), Marta Buszewicz (a1), Scott Weich (a2) and Michael King (a3)

Abstract

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.

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Copyright

Corresponding author

Kate Walters, Research Department of Primary Care & Population Health, Hampstead Campus, University College London, Rowland Hill St, London NW3 2PF, UK. Email: k.walters@ucl.ac.uk

Footnotes

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This study was supported by a Medical Research Council Special Training Fellowship in Health Services Research (G106/1053) for the main author (K.W.).

Declaration of interest

None.

Footnotes

References

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Mixed anxiety and depressive disorder outcomes: prospective cohort study in primary care

  • Kate Walters (a1), Marta Buszewicz (a1), Scott Weich (a2) and Michael King (a3)
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