Anxiety And Depression In Family Practice Patients With
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Anxiety And Depression In Family Practice Patients With

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    Anxiety And Depression In Family Practice Patients With Anxiety And Depression In Family Practice Patients With Presentation Transcript

    • ANXIETY AND DEPRESSION IN FAMILY PRACTICE PATIENTS WITH CO-MORBIDITIES Vojislav Ivetic, M.D. 1 Zalika Klemenc-Ketis, M.D. 1 Darinka Novak-Glavac, M.D. 2 Prof. Janko Kersnik , M.D. PhD. 1 1 Department of Family Medicine, University of Maribor, SLOVENIA 2 PHC Ljubljana, SLOVENIA
    • AIMS AND PURPOSE 1/2
      • S ymptoms of mental and physical illnesses overlap in family practice
      • In family practice m any patients present with co-morbidities rather than simple cases
      • Depression and anxiety account for a great part of all psychiatric diseases in family practice and they are associated with each other in 50 to 70% of the patients (Kaplan 1996).
    • EVERYDAY CHALLENGE WITH CO-MORBIDITIES IN FAMILY PRACTICE
    • AIMS AND PURPOSE 2/2
      • The aim of this study was to establish how often depression and anxiety are encountered by family practitioners and especially determine those risk groups where both disorders occur more often.
      • We hypothesized that anxiety and depression correlate with socio-demographic factors (age, gender, social status) and presence of chronic physical condition
    • DESIGN AND METHODS
      • We conducted a cross-sectional survey in 16 Slovenian family practice s
      • A total of 800 patients of both sexes , aged 18 to 90, were included in the sample.
      • They were asked to fill in an anonymous Zung self-rating form (Zung 1971), which besides anxiety and depression question included questions regarding age, sex, marital status, education, employment , as well as the presence of chronic pain and chronic somatic disease .
    • STATISTICAL ANALYSIS
      • We used the SPSS 13.0 package (SPSS Inc, Chicago, IL, USA)
      • To identify the statistically significant differences between different variables independent samples t-test and χ 2 test were calculated
      • To determine associations between the presence of anxiety and depression and patients’ characteristics, binary logistic regression was used
      • P value<0.05 was considered statistically significant
    • RESULTS 1/4 :
      • 712 forms were returned ( response rate 89%) ).
      • 386 ( 54.2% ) patients reported to have at least one chronic disease
      • Chronic pain was reported by 444 ( 62.4% ) of the patients
      • Analysis showed that 16.2 % of general practice visitors have depressive disorders, while 11.4 % have anxiety disorders.
    • ONE OF THE IMPROPER REASON FOR THE CHRONIC PAIN !
    • RESULTS 2/4 :
      • The following patients’ characteristics were found to be statistically significant in the prese nce of depression:
        • female vs. male (χ 2 =7.259, p=0.007),
        • patients with elementary and vocational education vs. others (χ 2 =9.910, p=0.002),
        • widowed and divorced patients vs. others (χ 2 =25.670, p<0.001),
        • patients with the presence of physical chronic disease vs. others (χ 2 =16.840, p<0.001) and
        • patients with higher degree of chronic pain (χ 2 =53.091, p<0.001).
    • RESULTS 3/4 :
      • The following patients’ characteristics were found to be statistically significant in the pres ence of anxiety:
        • female vs. male (χ 2 =3.905, p=0.048),
        • patients with elementary and vocational education vs. others (χ 2 =8.053, p=0.005),
        • widowed and divorced patients vs. others (χ 2 =17.647, p<0.001),
        • unemployed patients vs. others (χ 2 =8.981, p=0.011),
        • patients with the presence of physical chronic disease vs. others (χ 2 =17.259, p<0.001) and
        • patients with higher degree of chronic pain (χ 2 =57.824, p<0.001)
    • RESULTS 4/4 :
      • Women are twice as likely to develop depressive disorders, while anxiety is present in 13.2 % women and 8.0 % of men.
      • Loss of spouse or partner, social hardship (poverty, unemployment) and low level of education increase the risk for the development of a mental disorder.
      • Chronic pain increases the prevalence of anxiety and depression, with only 2.8 % of patients without chronic pain having anxiety disorders, while 26.8 % of subjects who rated their pain as 8 or more (VAS SCORE) had anxiety disorders.
    • ONE OF THE IMPROPER SOLUTIONS !
    • CONCLUSIONS:
      • Patients with chronic somatic illnesses have twice the risk to develop depressive disorders, especially those with a pronounced debilitating, repeating, advancing and life-threatening somatic illness (myocardial infarction, stroke, cancer, rheumatic disease).
      • The main limitations of this study are a non-random patients’ sample and a non-random sample of family practice settings , which can attribute to a selection bias. The other limitation is also patients’ self-reporting of chronic diseases .
    • THANK YOU VERY MUCH FOR YOUR ATTENTION,… Lake BLED TRIGLAV mountain POHORJE mountain skiing center Regards from Slovenia,….