The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study

BMC Psychiatry

Brenda WJH Penninx³  Harm WJ van Marwijk¹  Pim Cuijpers⁴  Peter FM Verhaak²  Ilse MJ van Beljouw² 

[1] Department of General Practice, VU University Medical Centre, Amsterdam, the Netherlands;Netherlands Institute for Health Services Research, Utrecht, the Netherlands;Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands;Department of Clinical Psychology, VU University, Amsterdam, the Netherlands

Others  :  1124663
DOI  :  10.1186/1471-244X-10-86

 received in 2010-03-27, accepted in 2010-10-20,  发布年份 2010

【 摘 要 】

Background

Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor outcome.

Method

Baseline and one-year follow-up data were used of 594 primary care patients with current anxiety or depressive disorders at baseline (established by the Composite Interview Diagnostic Instrument (CIDI)), from the Netherlands Study of Depression and Anxiety (NESDA). Receipt of and need for care were assessed by the Perceived Need for Care Questionnaire (PNCQ).

Results

In depression, treated and untreated patients with a perceived treatment need showed more rapid symptom decline but greater symptom severity at follow-up than untreated patients without a self-perceived mental problem or treatment need. A lower education level, lower income, unemployment, loneliness, less social support, perceived need for care, number of somatic disorders, a comorbid anxiety and depressive disorder and symptom severity at baseline predicted a poorer outcome in both anxiety and depression. When all variables were considered at the same time, only baseline symptom severity appeared to predict a poorer outcome in anxiety. In depression, a poorer outcome was also predicted by more loneliness and a comorbid anxiety and depressive disorder.

Conclusion

In clinical practice, special attention should be paid to exploring the need for care among possible risk groups (e.g. low social economic status, low social support), and support them in making an informed decision on whether or not to seek treatment.

【 授权许可】

   
2010 van Beljouw et al; licensee BioMed Central Ltd.

【 图 表 】

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