Anxiety and depression in family pracitce

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Anxiety and depression in family pracitce

  1. 1. EPIDEMIOLOGY OF MENTAL PROBLEMS IN FAMILY PRACTICE ATTENDERS JANKO KERSNIK Department of family medicine, University Ljubljana
  2. 2. Anxiety and depression <ul><li>High prevalence </li></ul><ul><li>High prevalence among primary care users </li></ul><ul><li>50% of primary care users was expected </li></ul><ul><li>AIM: To clarify the characteristics of the patients with mental disorders </li></ul>
  3. 3. Methods <ul><li>Cross-sectional study </li></ul><ul><li>Sample of family practice attenders </li></ul><ul><li>Structured self-administered questionnaire </li></ul><ul><li>Short Duke-AD questionnaire developed and tested by Parkerson and co-workers </li></ul>
  4. 4. Short Duke-AD questionnaire 1/2 <ul><li>Did these statements describe you? </li></ul><ul><ul><ul><li>0 = NOT TRUE </li></ul></ul></ul><ul><ul><ul><li>1 = PARTLY YES </li></ul></ul></ul><ul><ul><ul><li>2 = YES, TRUE FOR ME </li></ul></ul></ul><ul><ul><li>I give up easily </li></ul></ul><ul><ul><li>I concentrate with difficulty </li></ul></ul><ul><ul><li>I like to meet people ( reverse ) </li></ul></ul>
  5. 5. Short Duke-AD questionnaire 2/2 <ul><li>How much problems did you have last week </li></ul><ul><ul><ul><li>0 = no problem at all </li></ul></ul></ul><ul><ul><ul><li>1 = some problems </li></ul></ul></ul><ul><ul><ul><li>2 = a lot of problems </li></ul></ul></ul><ul><ul><li>with sleeping </li></ul></ul><ul><ul><li>with tiredness </li></ul></ul><ul><ul><li>feeling depressed </li></ul></ul><ul><ul><li>with nervousness </li></ul></ul>
  6. 6. Results - 1/2 <ul><li>82,1% response rate </li></ul><ul><li>The responses ranged from 0 to 14 points, mean 4,8 points (SD 2,8 points) </li></ul><ul><li>49,4% 5 ( cut point ) or more points </li></ul><ul><li>Females higher prevalence (51,5% vs. 45,5%; p=0,02 </li></ul><ul><ul><li>Females under 45 years had 30% higher probability; p=0,003 </li></ul></ul>
  7. 7. Results - 2/2 <ul><li>Higher number of symptoms: </li></ul><ul><li>Lower educational level (p<0,001) </li></ul><ul><li>Presence of chronic condition (p<0,001) </li></ul><ul><li>Experiencing nervousness in recent year (EuroQol dimension)  2,42 times higher probability (C.I. 2,15 - 2,73; p<0,001) </li></ul>
  8. 8. Conclusions 1/2 <ul><li>High prevalence - 49% </li></ul><ul><li>Predictors: </li></ul><ul><ul><li>Female gender (age < 45), </li></ul></ul><ul><ul><li>Lower educational level </li></ul></ul><ul><ul><li>Having a chronic condition </li></ul></ul>
  9. 9. Conclusions 2/2 <ul><li>Strategies to improve: </li></ul><ul><li>Active early detection/ first line Dg. </li></ul><ul><li>Further studies and interventions </li></ul><ul><li>Guidelines /awareness/ </li></ul><ul><li>Emphasise on appropriate communication skills </li></ul><ul><li>Training in coping with mental problems </li></ul><ul><li>Empowering (enabling) patients </li></ul>

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