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Prevalence and impact of generalized anxiety disorder and major depression in primary care in Belgium and Luxemburg: the GADIS study
- Marc Ansseau, Benjamin Fischler, Michel Dierick, Annick Mignon, Sophie Leyman
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- Journal:
- European Psychiatry / Volume 20 / Issue 3 / May 2005
- Published online by Cambridge University Press:
- 16 April 2020, pp. 229-235
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Purpose
GADIS aims at determining the prevalence of generalized anxiety disorder (GAD) and major depression (MD) in primary care and their impact on the patient’s functioning in Belgium and Luxemburg.
MethodsA large scale screening program was conducted at the consultation of general practitioners to detect patients with GAD and MD according to DSM-IV criteria. We collected additional data regarding the use of hypnotic, tranquilizer, antidepressant and analgesic medications. Impact on the patient was assessed with the Sheehan disability scale.
ResultsThree hundred GP’s in Belgium and Luxemburg were asked to screen 50 consecutive patients. Of the 13,677 analyzed patients, 8.3% were diagnosed to have GAD and 6.3% MD. Comorbidity was observed in 4.2% of patients. The prevalence was much higher in the French-speaking part of Belgium. GAD and MD were associated with impairment in social, familial and professional functioning. Only a minority of patients with GAD and/or MD was treated with an antidepressant and almost half of subjects with GAD and/or MD were treated with a tranquilizer.
ConclusionsPrevalence rates of GAD and MD in primary care in Belgium are comparable to other countries. GAD and MD are disabling conditions. Antidepressants are still used only in a minority of subjects with GAD and/or MD in primary care in Belgium and Luxemburg. The prevalence of GAD and MD appears to be much higher in French-speaking parts of Belgium.
Probability of major depression diagnostic classification using semi-structured versus fully structured diagnostic interviews
- Brooke Levis, Andrea Benedetti, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Matthew J. Chiovitti, Tatiana A. Sanchez, Pim Cuijpers, Simon Gilbody, John P. A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B. Patten, Ian Shrier, Russell J. Steele, Roy C. Ziegelstein, Dickens H. Akena, Bruce Arroll, Liat Ayalon, Hamid R. Baradaran, Murray Baron, Anna Beraldi, Charles H. Bombardier, Peter Butterworth, Gregory Carter, Marcos H. Chagas, Juliana C. N. Chan, Rushina Cholera, Neerja Chowdhary, Kerrie Clover, Yeates Conwell, Janneke M. de Man-van Ginkel, Jaime Delgadillo, Jesse R. Fann, Felix H. Fischer, Benjamin Fischler, Daniel Fung, Bizu Gelaye, Felicity Goodyear-Smith, Catherine G. Greeno, Brian J. Hall, John Hambridge, Patricia A. Harrison, Ulrich Hegerl, Leanne Hides, Stevan E. Hobfoll, Marie Hudson, Thomas Hyphantis, Masatoshi Inagaki, Khalida Ismail, Nathalie Jetté, Mohammad E. Khamseh, Kim M. Kiely, Femke Lamers, Shen-Ing Liu, Manote Lotrakul, Sonia R. Loureiro, Bernd Löwe, Laura Marsh, Anthony McGuire, Sherina Mohd Sidik, Tiago N. Munhoz, Kumiko Muramatsu, Flávia L. Osório, Vikram Patel, Brian W. Pence, Philippe Persoons, Angelo Picardi, Alasdair G. Rooney, Iná S. Santos, Juwita Shaaban, Abbey Sidebottom, Adam Simning, Lesley Stafford, Sharon Sung, Pei Lin Lynnette Tan, Alyna Turner, Christina M. van der Feltz-Cornelis, Henk C. van Weert, Paul A. Vöhringer, Jennifer White, Mary A. Whooley, Kirsty Winkley, Mitsuhiko Yamada, Yuying Zhang, Brett D. Thombs
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- Journal:
- The British Journal of Psychiatry / Volume 212 / Issue 6 / June 2018
- Published online by Cambridge University Press:
- 02 May 2018, pp. 377-385
- Print publication:
- June 2018
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Background
Different diagnostic interviews are used as reference standards for major depression classification in research. Semi-structured interviews involve clinical judgement, whereas fully structured interviews are completely scripted. The Mini International Neuropsychiatric Interview (MINI), a brief fully structured interview, is also sometimes used. It is not known whether interview method is associated with probability of major depression classification.
AimsTo evaluate the association between interview method and odds of major depression classification, controlling for depressive symptom scores and participant characteristics.
MethodData collected for an individual participant data meta-analysis of Patient Health Questionnaire-9 (PHQ-9) diagnostic accuracy were analysed and binomial generalised linear mixed models were fit.
ResultsA total of 17 158 participants (2287 with major depression) from 57 primary studies were analysed. Among fully structured interviews, odds of major depression were higher for the MINI compared with the Composite International Diagnostic Interview (CIDI) (odds ratio (OR) = 2.10; 95% CI = 1.15–3.87). Compared with semi-structured interviews, fully structured interviews (MINI excluded) were non-significantly more likely to classify participants with low-level depressive symptoms (PHQ-9 scores ≤6) as having major depression (OR = 3.13; 95% CI = 0.98–10.00), similarly likely for moderate-level symptoms (PHQ-9 scores 7–15) (OR = 0.96; 95% CI = 0.56–1.66) and significantly less likely for high-level symptoms (PHQ-9 scores ≥16) (OR = 0.50; 95% CI = 0.26–0.97).
ConclusionsThe MINI may identify more people as depressed than the CIDI, and semi-structured and fully structured interviews may not be interchangeable methods, but these results should be replicated.
Declaration of interestDrs Jetté and Patten declare that they received a grant, outside the submitted work, from the Hotchkiss Brain Institute, which was jointly funded by the Institute and Pfizer. Pfizer was the original sponsor of the development of the PHQ-9, which is now in the public domain. Dr Chan is a steering committee member or consultant of Astra Zeneca, Bayer, Lilly, MSD and Pfizer. She has received sponsorships and honorarium for giving lectures and providing consultancy and her affiliated institution has received research grants from these companies. Dr Hegerl declares that within the past 3 years, he was an advisory board member for Lundbeck, Servier and Otsuka Pharma; a consultant for Bayer Pharma; and a speaker for Medice Arzneimittel, Novartis, and Roche Pharma, all outside the submitted work. Dr Inagaki declares that he has received grants from Novartis Pharma, lecture fees from Pfizer, Mochida, Shionogi, Sumitomo Dainippon Pharma, Daiichi-Sankyo, Meiji Seika and Takeda, and royalties from Nippon Hyoron Sha, Nanzando, Seiwa Shoten, Igaku-shoin and Technomics, all outside of the submitted work. Dr Yamada reports personal fees from Meiji Seika Pharma Co., Ltd., MSD K.K., Asahi Kasei Pharma Corporation, Seishin Shobo, Seiwa Shoten Co., Ltd., Igaku-shoin Ltd., Chugai Igakusha and Sentan Igakusha, all outside the submitted work. All other authors declare no competing interests. No funder had any role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.
Prevalencia y repercusiones del trastorno de ansiedad generalizada y la depresión mayor en la atención primaria en Bélgica y Luxemburgo: el estudio GADIS
- Marc Ansseaua, Benjamin Fischler, Michel Dierick, Annick Mignond, Sophie Leymand
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- Journal:
- European Psychiatry (Ed.Española) / Volume 12 / Issue 7 / October 2005
- Published online by Cambridge University Press:
- 12 May 2020, pp. 363-370
- Print publication:
- October 2005
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Propísito
El estudio GADIS pretende determinar la prevalencia del trastorno de ansiedad generalizada (TAG) y la depresión mayor (DM) en atención primaria y sus repercusiones en el funcionamiento del paciente en Bélgica y Luxemburgo.
MétodoSe llevó a cabo un programa de detección selectiva a gran escala en la consulta de médicos generales para detectar a los pacientes con TAG y DM según los criterios del DSM-IV. Recogimos datos adicionales acerca del uso de medicamentos hipnóticos, tranquilizantes, antidepresivos y analgésicos. Las repercusiones en el paciente se evaluaron con la Escala de Discapacidad de Sheehan.
ResultadosSe pidió a 300 médicos generales en Bélgica y Luxemburgo que hicieran una detección selectiva en 50 pacientes consecutivos. De los 13.677 pacientes analizados, se diagnosticó que el 8,3% tenía TAG y el 6,3%, DM. Se observó comorbilidad en un 4,2% de los pacientes. La prevalencia era mucho más alta en la parte de habla francesa de Bélgica. El TAG y la DM se asociaban con deterioro en el funcionamiento social, familiar y profesional. Sólo una minoría de pacientes con TAG, DM o ambos trastomos recibía tratamiento con un antidepresivo y casi la mitad de los sujetos con TAG, DM o ambos trastomos se trataba con un tranquilizante.
ConclusiónLas tasas de prevalencia del TAG y la DM en la atención primaria en Belgica son comparables a otros países. El TAG y la DM son afecciones incapacitantes. Los antidepresivos se utilizan todavía sólo en una minoróa de sujetos con TAG, DM o ambos trastomos en atención primaria en Bélgica y Luxemburgo. La prevalencia del TAG y la DM parece ser mucho más alta en las partes de habla francesa de Bélgica.
Attention and verbal learning in patients with Chronic Fatigue Syndrome
- VERONIQUE MICHIELS, RAYMOND CLUYDTS, BENJAMIN FISCHLER
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- Journal:
- Journal of the International Neuropsychological Society / Volume 4 / Issue 5 / September 1998
- Published online by Cambridge University Press:
- 01 September 1998, pp. 456-466
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Former neuropsychological studies with Chronic Fatigue Syndrome (CFS) patients evaluated a broad range of cognitive functions. Several, but not all, reported subtle attentional and memory impairments suggesting possible mild cerebral involvement. In this study, a battery of attentional tests and a verbal memory task were administered to 20 CFS patients and 22 healthy controls (HC) in order to clarify the specific nature of attention and memory impairment in these patients. The results provide evidence for attentional dysfunction in patients with CFS as compared to HC. CFS patients performed more poorly on a span test measuring attentional capacity and working memory. Speeded attentional tasks with a more complex element of memory scanning and divided attention seem to be a sensitive measure of reduced attentional capacity in these patients. Focused attention, defined as the ability to attend to a single stimulus while ignoring irrelevant stimuli, appears not to be impaired. CFS patients were poorer on recall of verbal information across learning trials, and poor performance on delayed recall may be due to poor initial learning and not only to a retrieval failure. (JINS, 1998, 4, 456–466.)