We assessed whether a coexisting anxiety disorder predicts risk for persistent depression in primary care patients with major depression at baseline.
Patients with major depression were identified in a 12-month prospective cohort study at a University-basea famil practice clinic.
Presence of an anxiety disorder and other potential prognostic factors were measured at baseline.
Persistent depressive illness (major depression, minor depression, or dysthymia) was determined at 12 months.
Of 85 patients with major depression at baseline, 43 had coexisting anxiety disorder (38 with social phobia).
The risk for persistent depression at 12 months was 44% greater [Risk Ratio (RR)=1.44,95% confidence interval (CI) 1.02-2.04] in those with coexisting anxiety.
This risk persisted in stratified analysis controlling for other prognostic factors.
Patients with coexisting anxiety had greater mean depressive severity [repeated measures analysis of variance (ANOVA), p<0.04] and total disability days (54.9 vs 19.8, p<0.02) over the 12-month study.
Patients with social phobia had similar increased risk for persistent depression (RR=1.40,95% CI 0.98-2.00).
A coexisting anxiety disorder indicates risk for persistent depression in primary care patients with major depression.
Social phobia may be important to recognize in these patients.
Identifying anxiety disorders can help primary care clinicians target patients needing more aggressive treatment for depression.
Mots-clés Pascal : Etat dépressif, Soin santé primaire, Association morbide, Phobie sociale, Prédiction, Chronicité, Facteur risque, Santé mentale, Etats Unis, Amérique du Nord, Amérique, Etude longitudinale, Homme, Trouble humeur, Trouble anxieux
Mots-clés Pascal anglais : Depression, Primary health care, Concomitant disease, Social phobia, Prediction, Chronicity, Risk factor, Mental health, United States, North America, America, Follow up study, Human, Mood disorder, Anxiety disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0374407
Code Inist : 002B18C07A. Création : 22/03/2000.