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Managing complex problems: treatment for common mental disorders in the UK

Published online by Cambridge University Press:  18 May 2011

Andre Tylee  and
Mark Haddad
Andre Tylee*
Affiliation:
Department of Population & Health Service Research, King's College, London (United Kingdom)
Mark Haddad
Affiliation:
Department of Population & Health Service Research, King's College, London (United Kingdom)
*
Address for correspondence: Professor A. Tylee, Department of Population & Health Service Research, King's College London, PO28 Institute of Psychiatry, De Crespigny Park, London SE5 8AF (United Kingdom). Fax: 444(0)207 848 0333 E-mail: a.tylee@iop.kcl.ac.uk; m.haddad@iop.kcl.ac.uk
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Summary

Aims – This paper aims to describe current trends in the UK primary care management of common mental disorders and explore the appropriateness of differing management approaches in light of the course and common complications of these disorders. Methods – It highlights key findings concerning the course and comorbidity of depression to indicate that depression and associated mental illnesses may often form part of more complex patterns of ill health and that these conditions have a clear potential for chronicity. A narrative review of studies providing detail of depression prevalence in selected comorbid conditions is presented for this purpose. Conclusion – The presentation and course of common mental disorders indicate organizational changes in health service delivery, and - for a sizeable patient group – the use of chronic disease management strategies.

Declaration of Interest: None.

Keywords

depressioncomorbidityprimary caredelivery of health care
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 16 , Issue 4 , December 2007 , pp. 302 - 308
Copyright
Copyright © Cambridge University Press 2007

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References

REFERENCES

Abas, M., Hotopf, M. & Prince, M. (2002). Depression and mortality in a high-risk population. 11-Year follow-up of the Medical Research Council Elderly Hypertension Trial. British Journal of Psychiatry 181, 123–128.Google Scholar
Ahern, D.K., Gorkin, L., Anderson, J.L., Tierney, C., Hallstrom, A., Ewart, C, Capone, R.J., Schron, E., Kornfeld, D. & Herd, J.A. (1990). Biobehavioral variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study (CAPS). American Journal of Cardiology 66, 59–62.CrossRefGoogle ScholarPubMed
Anderson, R.J., Freedland, K.E., Clouse, R.E. & Lustman, P.J. (2001). The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 24, 1069–1078.CrossRefGoogle ScholarPubMed
Ashworth, M. & Armstrong, D. (2006). The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK Quality and Outcomes Framework, 2004-5. BMC Family Practice 7, 68.CrossRefGoogle ScholarPubMed
Brown, K.W., Levy, A.R., Rosberger, Z. & Edgar, L. (2003). Psychological distress and cancer survival: a follow-up 10 years after diagnosis. Psychosomatic Medicine 65, 636–643.CrossRefGoogle ScholarPubMed
Burvill, P., Johnson, G., Jamrozik, K., Anderson, C. & Stewart-Wynne, E. (1997). Risk factors for post-stroke depression. International Journal of Geriatric Psychiatry 12, 219–226.3.0.CO;2-E>CrossRefGoogle ScholarPubMed
Bush, D.E., Ziegelstein, R.C., Tayback, M., Richter, D., Stevens, S., Zahalsky, H. & Fauerbach, J.A. (2001). Even minimal symptoms of depression increase mortality risk after acute myocardial infarction. American Journal of Cardiology 88, 337–341.CrossRefGoogle ScholarPubMed
Casacalenda, N., Perry, J.C. & Looper, K. (2002). Remission in major depressive disorder: a comparison of pharmacotherapy, psychotherapy, and control conditions. American Journal of Psychiatry 159, 1354–1360.CrossRefGoogle ScholarPubMed
Chwastiak, L., Ehde, D.M., Gibbons, L.E., Sullivan, M., Bowen, J.D. & Kraft, G.H. (2002). Depressive symptoms and severity of illness in multiple sclerosis: epidemiologic study of a large community sample. American Journal of Psychiatry 159, 1862–1868.CrossRefGoogle ScholarPubMed
Dietrich, A.J., Oxman, T.E., Williams, J.W. Jr., Schulberg, H.C., Bruce, M.L., Lee, P.W., Barry, S., Raue, P.J., Lefever, J.J., Heo, M., Rost, K., Kroenke, K., Gerrity, M. & Nutting, P.A. (2004). Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial. British Medical Journal 329, 602–608.CrossRefGoogle ScholarPubMed
European Commission Health & Consumer Protection Directorate-General (2005). Green Paper. Improving the Mental Health of the Population: Towards a Strategy on Mental Health for the European Union. COM(2005)484. European Commission: Brussels.Google Scholar
Geerlings, S.W., Beekman, A.T., Deeg, D.J., Twisk, J.W. & van Tilburg, W. (2002). Duration and severity of depression predict mortality in older adults in the community. Psychological Medicine 32, 609–618.CrossRefGoogle ScholarPubMed
Glassman, A.H. & Shapiro, P.A. (1998). Depression and the Course of Coronary Artery Disease. American Journal of Psychiatry 155, 4–11.Google ScholarPubMed
Goldberg, D. (2006). The "NICE Guideline" on the treatment of depression. Epidemiologia e Psichiatria Sociale 15, 11–15.Google Scholar
Haddad, P.M. (2004). Antipsychotics and diabetes: review of non-prospective data. British Journal of Psychiatry 47, S80–S86.CrossRefGoogle ScholarPubMed
House, A. & Stark, D. (2002). Anxiety in medical patients. British Medical Journal 325, 207–209.CrossRefGoogle ScholarPubMed
Judd, L.L., Akiskal, H.S., Maser, J.D., Zeller, P.J., Endicott, J., Coryell, W., Paulus, M.P., Kunovac, J.L., Leon, A.C., Mueller, T.I., Rice, J.A. & Keller, M.B. (1998). A prospective 12-year study of subsyndromal and syndromal depressive symptoms in unipolar major depressive disorders. Archives of General Psychiatry 55, 694–700.CrossRefGoogle ScholarPubMed
Kennedy, N., Abbott, R. & Paykel, E.S. (2004). Longitudinal syndromal and sub-syndromal symptoms after severe depression: 10-year follow-up study. British Journal of Psychiatry 184, 330–336.CrossRefGoogle ScholarPubMed
Kessler, R.C., Keller, M.B. & Wittchen, H.U. (2001). The epidemiology of generalized anxiety disorder. Psychiatric Clinics of North America 24, 19–39.CrossRefGoogle ScholarPubMed
Krishnan, K.R., Delong, M., Kraemer, H., Carney, R., Spiegel, D., Gordon, C, McDonald, W., Dew, M., Alexopoulos, G., Buckwalter, K., Cohen, P.D., Evans, D., Kaufmann, P.G., Olin, J., Otey, E. & Wainscott, C. (2002). Comorbidity of depression with other medical diseases in the elderly. Biological Psychiatry 52, 559–588.CrossRefGoogle ScholarPubMed
Lai, S.M., Duncan, P.W., Keighley, J. & Johnson, D. (2002). Depressive symptoms and independence in BADL and IADL. Journal of Rehabilitation Research and Development 39, 589–596.Google ScholarPubMed
Lasser, K., Boyd, J.W., Woolhandler, S., Himmelstein, D.U., McCormick, D. & Bor, D.H. (2000). Smoking and mental illness: A population-based prevalence study. Journal of the American Medical Association 284, 2606–2610.CrossRefGoogle ScholarPubMed
Layard, R. (2004). Mental Health: Britain's Biggest Social Problem? Strategy Unit Seminar Paper: RL414c. Retrieved September 20, 2007, from http://www.strategy.gov.uk/downloads/files/mh_layard.pdf.Google Scholar
Layard, R. (2006). The case for psychological treatment centres. British Medical Journal,332 1030–1032.CrossRefGoogle ScholarPubMed
Lenze, E.J., Rogers, J.C., Martire, L.M., Mulsant, B.H., Rollman, B.L., Dew, M.A., Schulz, R. & Reynolds, C.F. III, (2001). The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. American Journal of Geriatric Psychiatry 9, 113–135.Google ScholarPubMed
Lett, H.S., Blumenthal, J.A., Babyak, M.A., Sherwood, A., Strauman, T., Robins, C. & Newman, M.F. (2004). Depression as a risk factor for coronary artery disease: evidence, mechanisms, and treatment. Psychosomatics Medicine 66(3), 305–315.Google ScholarPubMed
Malzberg, B. (1937). Mortality among patients with involutional melancholia. American Journal of Psychiatry 93, 1231–1238.CrossRefGoogle Scholar
Milani, R.V. & Lavie, C.J. (1998). Prevalence and effects of cardiac rehabilitation on depression in the elderly with coronary heart disease. American Journal of Cardiology 81, 1233–1236.Google ScholarPubMed
NICE (2004a). Anxiety: Management of Anxiety (Panic Disorder, with or without Agoraphobia, and Generalised Anxiety Disorder) in Adults in Primary, Secondary and Community Care. National Institute for Clinical Excellence: London.Google Scholar
NICE (2004b). Depression: Management of Depression in Primary and Secondary Care. National Clinical Practice Guideline Number 23. National Collaborating Centre for Mental Health Commissioned by the National Institute for Clinical Excellence. Retrieved September 20, 2007, from http://www.nice.org.uk/pdf/cg023fullguideline.pdf.Google Scholar
Office of the Surgeon General (1999). Mental Health: A Report of the Surgeon General. United States Department of Health & Human Services: Washington DC.Google Scholar
Panzarino, P.J. Jr., (1998). The costs of depression: direct and indirect; treatment versus nontreatment. Journal of Clinical Psychiatry 59, Suppl. 20, 11–14.Google Scholar
Paykel, E.S. (2006). Depression: major problem for public health. Epidemiologia e Psichiatria Sociale 15, 4–10.CrossRefGoogle ScholarPubMed
Payne, A. & Steadman, T. (2005). Quality and Outcomes Framework (QOF). Report of the Evaluation and Review of the QOF Process. Health Quality Service: London.Google Scholar
Penninx, B.W., Guralnik, J.M., Pahor, M., Ferrucci, L., Cerhan, J.R., Wallace, R.B. & Havlik, R.J. (1998). Chronically depressed mood and cancer risk in older persons. Journal of the National Cancer Institute, 90 1888-1893.CrossRefGoogle ScholarPubMed
Penninx, B.W., Beekman, A.T., Honig, A., Deeg, D.J., Schoevers, R.A., van Eijk, J.T. & van Tilburg, W. (2001). Depression and cardiac mortality: results from a community-based longitudinal study. Archives of General Psychiatry 58, 221–227.CrossRefGoogle ScholarPubMed
Robinson, L.A., Berman, J.S. & Neimeyer, R.A. (1990). Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research. Psychological Bulletin 108, 30–49.CrossRefGoogle ScholarPubMed
Robinson, R.G. (2003). Poststroke depression: prevalence, diagnosis, treatment, and disease progression. Biological Psychiatry 54, 376–387.CrossRefGoogle ScholarPubMed
Rost, K., Nutting, P., Smith, J.L., Elliott, C.E. & Dickinson, M. (2002). Managing depression as a chronic disease: a randomised trial of ongoing treatment in primary care. British Medical Journal 325, 934.CrossRefGoogle ScholarPubMed
Rudisch, B. & Nemeroff, C.B. (2003). Epidemiology of comorbid coronary artery disease and depression. Biological Psychiatry 54, 227–240.CrossRefGoogle Scholar
Schleifer, S.J., Macari-Hinson, M.M., Coyle, D.A., Slater, W.R., Kahn, M., Gorlin, R. & Zucker, H.D. (1989). The nature and course of depression following myocardial infarction. Archives of Internal Medicine 149, 1785–1789.CrossRefGoogle ScholarPubMed
Schoevers, R.A., Beekman, A.T.F., Tilburg, W.V., Egg, D.H.J., Jonker, C., Geerlings, M.I. & Penninx, B.W.J.H. (2000). Association of depression and gender with mortality in old age: Results from the Amsterdam Study of the Elderly (AMSTEL). British Journal of Psychiatry 177, 336–342.CrossRefGoogle ScholarPubMed
Scott, J. (2006). Depression should be managed like a chronic disease. British Medical Journal 332, 985–986.CrossRefGoogle ScholarPubMed
Tylee, A. (2006). Identifying and managing depression in primary care in the United Kingdom. Journal of Clinical Psychiatry 67, Suppl 6, 41–45.Google Scholar
van Ede, L., Yzermans, C.J. & Brouwer, H.J. (1999). Prevalence of depression in patients with chronic obstructive pulmonary disease: a systematic review. Thorax 54, 688–692.CrossRefGoogle ScholarPubMed
Von Korff, M. & Goldberg, D. (2001). Improving outcomes in depression. British Medical Journal 323, 948–949.CrossRefGoogle ScholarPubMed
Wagena, E.J., van Amelsvoort, L.G., Kant, I. & Wouters, E.F. (2005). Chronic bronchitis, cigarette smoking, and the subsequent onset of depression and anxiety: results from a prospective population-based cohort study. Psychosomatic Medicine 67, 656–660.CrossRefGoogle ScholarPubMed
Weintraub, D., Oehlberg, K.A., Katz, I.R. & Stern, M.B. (2006). Test characteristics of the 15-item geriatric depression scale and hamilton depression rating scale in Parkinson disease. American Journal of Geriatric Psychiatry 14, 169–175.CrossRefGoogle ScholarPubMed
World Health Organisation (2001). The World Health Report 2001: Mental Health New Understanding, New Hope. WHO: Geneva.Google Scholar
Wright, N., Smeeth, L. & Heath, I. (2003). Moving beyond single and dual diagnosis in general practice. British Medical Journal 326, 512–514.CrossRefGoogle ScholarPubMed
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M. & Leirer, V.O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research 17, 37–49.CrossRefGoogle Scholar
Yohannes, A.M., Baldwin, R.C. & Connolly, M.J. (2000). Depression and anxiety in elderly outpatients with chronic obstructive pulmonary disease: prevalence, and validation of the BASDEC screening questionnaire. International Journal of Geriatric Psychiatry 15, 1090–1096.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Zigmond, A.S. & Snaith, R.P. (1983). The hospital anxiety and depression scale. Ada Psychiatrica Scandinavica 67, 361–370.CrossRefGoogle ScholarPubMed