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Accuracy of general practitioner's prognosis of the 1-year course of depression and generalised anxiety

  • Rob H. S. Van Den Brink (a1), Johan Ormel (a1), Klaas Van Der Meer (a2), Bea G. Tiemens (a1), Titus W. D. P. Van Os (a1), Annet Smit (a1) and Jack A. Jenner (a1)...

Abstract

Background

A prognosis serves important functions for the management of common mental disorders in primary care.

Aims

To establish the accuracy of the general practitioner's (GP) prognosis.

Method

The agreement between GP prognosis and observed course was determined for 138 cases of ICD–10 depression and 65 of generalised anxiety disorder, identified among consecutive attenders of 18 GPs.

Results

Modest agreement between GP prognosis and course was found, both for depression (κ=0.21) and generalised anxiety (κ=0.111). Better agreement (κ=0.45 for depression, and κ=0.33 for generalised anxiety) was observed between the course and predictions from a statistical model based on information potentially available to the GP at the time the prognosis was made. This model assesses attainable performance for GPs.

Conclusions

General practitioners do a fair job in predicting the 1-year course of depression and generalised anxiety. Even so, their performance falls significantly short of attainable performance.

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Copyright

Corresponding author

Dr R. H. S. Van den Brink, Department of Psychiatry, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Tel: +31 50 3612089; fax: +31 50 3619722; e-mail: r.h.s.van.den.brink@med.rug.nl

Footnotes

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Declaration of interest

No conflict of interest. Public funding detailed in Acknowledgements.

Footnotes

References

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Brown, G. W., Adler, Z. & Bifulco, A. (1988) Life events, difficulties and recovery from chronic depression. British Journal of Psychiatry, 152, 487498.
Brown, G. W., Lemyre, L. & Bifulco, A. (1992) Social factors and recovery from anxiety and depressive disorders: a test of specificity. British Journal of Psychiatry, 161, 4454.
Cooper-Patrick, L., Crum, R. M. & Ford, D. E. (1994) Characteristics of patients with major depression who required care in general medical and specialty health settings. Medical Care, 32, 1524.
Davies, M. H., Rose, S. & Cross, K. W. (1983) Life events, social interaction and psychiatric symptoms in general practice: a pilot study. Psychological Medicine, 13, 159163.
Gibbons, J. D. (1993) Nonparametric Measures of Association. Newbury Park, CA: Sage.
Goldberg, D. (1992) A classification of psychological distress for use in primary care settings. Social Science and Medicine, 35, 189193.
Goldberg, D. & Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER–Nelson.
Goldberg, D. & Lecrubier, Y. (1995) Form and frequency of mental disorders across centres. In Mental Illness in General Health Care: An International Study (eds Üstün, T. B. & Sartorius, N.), pp. 323334. Chichester: John Wiley & Sons.
Hammond, K. R., Stewart, T. R., Brehmer, B., et al (1975) Social judgment theory. In Human Judgment and Decision Processes (eds Kaplan, M. F. & Schwartz, S.), pp. 271312. New York: Academic Press.
Jenner, J. A., Van der Meer, K., Van Os, T. W. D. P., et al (1995) Psychosociale klachten in de huisartspraktijk; een cursus voor huisartsen. Assen: Van Gorcum.
Katon, W., Lin, E., VonKorff, M., et al (1994) The predictors of persistence of depression in primary care. Journal of Affective Disorders, 31, 8190.
Leenstra, A. S., Ormel, J. & Giel, R. (1995) Positive life change and recovery from depression and anxiety: a three-stage longitudinal study of primary care attenders. British Journal of Psychiatry, 166, 333343.
Norusis, M. J. (1990) SPSS/PC+4.0 Base Manual. Chicago, IL. SPSS Inc.
Ormel, J., Oldehinkel, A., Birlman, E., et al (1993) Outcome of depression and anxiety in primary care; a three-wave 3½-year study of psychopathology and disability. Archives of General Psychiatry, 50, 759766.
Ronalds, C., Creed, F., Stone, K., et al (1997) Outcome of anxiety and depressive disorders in primary care. British Journal of Psychiatry, 171, 427433.
Sartorius, N., Üstün, T. B., Lecrubier, Y., et al (1996) Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care. British Journal of Psychiatry, 168 (suppl. 30), 3843.
Sherbourne, C. D., Jackson, C. A., Meredith, L. S., et al (1996) Prevalence of comorbid anxiety disorders in primary care outpatients. Archives of Family Medicine, 5, 2734.
Sireling, L. I., Freeling, P., Paykel, E. S., et al (1985) Depression in general practice: clinical features and comparison with out-patients. British Journal of Psychiatry, 147, 119126.
Spijker, J. & Nolen, W. A. (1998) Voorspellende factoren voor chroniciteit van een depressie. Tijdschrift voor Psychiatrie, 40, 696708.
Tiemens, B. G., Ormel, J. & Simon, G. E. (1996) Occurrence, recognition and outcome of psychological disorders in primary care. American Journal of Psychiatry, 153, 636644.
Tiemens, B. G., Ormel, J. Jenner, J. A., et al (1999) Training primary care physicians to recognise, diagnose and manage depression: does it improve patient outcomes? Psychological Medicine, 29, 833845.
Üstün, T. B. & VonKorff, M. (1995) Primary mental health services: access and provision of care. In Mental Illness in General Health Care: An International Study (eds Üstün, T. B. & Sartorius, N.), pp. 347360. Chichester: John Wiley & Sons.
Van Os, T. W. D. P., Ormel, J., Van den Brink, R. H. S., et al (1999) Training primary care physicians improves the management of depression. General Hospital Psychiatry, 21, 168176.
VonKorff, M. & Üstün, T. B. (1995) Methods of the WHO collaborative project on psychological problems in general health care. In Mental Illness in General Health Care: An International Study (eds Üstün, T. B. & Sartorius, N.), pp. 1938. Chichester: John Wiley & Sons.
World Health Organization (1990) Composite International Diagnostic Interview (CIDI) (version 1.0). Geneva: WHO.
World Health Organization (1993) The ICD–10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. Geneva: WHO.

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Accuracy of general practitioner's prognosis of the 1-year course of depression and generalised anxiety

  • Rob H. S. Van Den Brink (a1), Johan Ormel (a1), Klaas Van Der Meer (a2), Bea G. Tiemens (a1), Titus W. D. P. Van Os (a1), Annet Smit (a1) and Jack A. Jenner (a1)...
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