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Depression Comorbid with Anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care

Published online by Cambridge University Press:  06 August 2018

Nornam Sartorius ,
T. Bedirhan Üstün ,
Yves Lecrubier  and
Hans-Ulrich Wittchen
Nornam Sartorius
Affiliation:
Department of Psychiatry, University of Geneva, Geneva, Switzerland
T. Bedirhan Üstün*
Affiliation:
Division of Mental Health, World Health Organization, Geneva, Switzerland
Yves Lecrubier
Affiliation:
Inserm Unite 302, Paris, France
Hans-Ulrich Wittchen
Affiliation:
Max-Planck Institute fur Psychiatrie, Klinisches Institut, Munchen, Germany; and all the investigators in the WHO Collaborative Study on Psychological Problems in General Health Care
*
Dr T. B. Üstün, Division of Mental Health, World Health Organization, CH-1211 Geneva 27, Switzerland
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Abstract

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 25 916 adults who consulted health-care services. The second-stage assessment (n=5438) consisted of the Composite International Diagnostic Interview (GDI), 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.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 168 , Issue S30: Comorbidity of Mood Disorders , June 1996 , pp. 38 - 43
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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Footnotes

1.

Investigators from participating centres are: O. Öztürk, M. Rezaki (Ankara); C. Stefanis, V. Mavreas (Athens); S. M. Channabasavanna, T. g. Sriram (Bangalore); H. Helmchen, M. Linden (Berlin); W. van den Brink, B. Tiemens (Groningen); M. Olatawura, O. Gureje (Ibadan); O. Benkert, W. Maier (Mainz); R. Gater, S. Kisely (Manchester); Y. Nakane, M. Michitsuji (Nagasaki); Y. Lecrubier, P. Boyer (Paris); J. A. Costa e Silva, L. Villano (Rio de Janiero); R. Florenzano, J. Acuño (Santiago de Chile); G. Simon, M. Von Korff (Seattle); Yan He-Qin, Xaio Shi Fu (Shanghai); M. Tansella, C. Bellantuono (Verona).

References

Coulehan, J. L., Schulberg, H. C., Block, M. R., et al (1990) Depressive symptomatology and medical co-morbidity in a primary care clinic. International Journal of Psychiatry in Medicine, 20, 335–347.CrossRefGoogle Scholar
Goldberg, D. P. & Williams, P. (1988) A User Guide to the General Health Questionnaire: GHQ. Windsor: NFER-Nelson.Google Scholar
Kessler, R. C., McGonagle, K. A., Zhao, S., et al (1994) Lifetime and 12 month prevalence of DSM–III–R psychiatric disorders in the United States. Archives of General Psychiatry, 51, 8–193.Google Scholar
Noyes, R. J., Woodman, C., Garvey, M. F., et al (1992) Generalized anxiety disorder v. panic disorder: distinguishing characteristics and patterns of comorbidity. Journal of Nervous and Mental Disease, 180, 369–379.CrossRefGoogle Scholar
Ormel, J., Von Korff, M., Üstün, T. B., et al (1966) Psychopathology and disability are associated across the world: Results from the WHO Collaborative Study. Journal of the American Medical Association, (in press).Google Scholar
Sanderson, W. C., Beck, A. T. & Beck, J. (1990) Syndrome comorbidity in patients with major depression or dysthymia: prevalence and temporal relationships. American Journal of Psychiatry, 147, 1025–1028.Google Scholar
Sartorius, N., Üstün, T. B., Costa E Silva, J. A., et al (1993) An international study of psychological problems in primary care. Archives of General Psychiatry, 50, 819–824.CrossRefGoogle Scholar
Üstün, T. B. & Sartorius, N. (1995) Mental Illness in General Health Care: An International Study. Chichester: Wiley.Google Scholar
Wittchen, H.-U., Essau, C. A. & Krieg, J. C. (1991) Anxiety disorders: Similarities and differences of comorbidity in treated and untreated groups. British Journal of Psychiatry, 159 (suppl. 12), 23–33.CrossRefGoogle Scholar
Wittchen, H.-U. & Essau, C. A. (1993) Comorbidity and mixed anxiety–depressive disorders: is there epidemiologic evidence? Journal of Clinical Psychiatry, 54, 9–15.Google Scholar
Zung, W. W. K., Magruder-Habib, K., Velez, R., et al (1990) The comorbidity of anxiety and depression in general medical patients: a longitudinal study. Journal of Clinical Psychiatry, 51, 77–80.Google ScholarPubMed
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