Wiener klinische Wochenschrift

, Volume 122, Issue 19–20, pp 567–571 | Cite as

Longstanding disease, disability or infirmity and depression in primary care

  • Janez Rifel
  • Igor Švab
  • Danica Rotar Pavlič
  • Michael King
  • Irwin Nazareth
Original article


CONTEXT: Current evidence suggests that depression is much more prevalent among those with chronic medical conditions compared to the general population. Depression will rank second to cardiovascular disease as a global cause of disability by 2020. With ageing of the population physicians are called upon to treat a higher percentage of patients with chronic medical illness. OBJECTIVE: To assess the prevalence and incidence of depression and likelihood for new-onset depression in patients with self-reported longstanding disease, disability or infirmity in the sample of primary care attendees. METHODE: Consecutive family medicine practice attendees aged 18 to 75 years were recruited and followed up after six months. Presence of longstanding disease, disability or infirmity was recorded. RESULTS: Prevalence of major depression was 8.9% in the group of patients reporting longstanding disease compared to 3.1% in the group without longstanding disease. Incidence of major depression after 6 months was 2.7% in the group with longstanding disease and 0.9% in the group without longstanding disease. For the patients with longstanding disease at the baseline it was almost 4 times more likely to have major depression after 6 months than for patients who did not report any longstanding disease at the baseline. CONCLUSION: The associations between longstanding disease and depression are important in primary care setting.


Depression Chronic disease Comorbidity Primary care Incidence 

Langjährige Erkrankung, Behinderung oder Gebrechlichkeit und Depression in der medizinischen Grundversorgung


INHALT: Allgemein anerkannte Ergebnisse weisen darauf hin, dass Depression bei Personen mit chronischen Leiden häufiger auftritt als allgemein in der Bevölkerung. Depression wird als weltweite Ursache für Behinderung bis zum Jahr 2020 an zweiter Stelle nach Herz-Kreislauf-Erkrankungen rangieren. Ärzte sind aufgrund des Alterns der Bevölkerung gefordert, einen höheren Anteil an chronisch erkrankt Patienten zu behandeln. ZIEL: Beurteilung des Vorherrschens und Auftretens von Depression und der Wahrscheinlichkeit für neu ausbrechende Depression bei Patienten mit selbst berichteter langjähriger Erkrankung, Behinderung oder Gebrechlichkeit in der Teilnehmerprobe der medizinischen Grundversorgung. METHODE: Besucher einer Allgemeinmedizinpraxis im Alter von 18 bis 75 Jahren wurden einer nach dem anderen aufgenommen und über sechs Monate (erste Etappe) untersucht. Langjährige Erkrankung, Behinderung oder Gebrechlichkeit wurden festgestellt. ERGEBNISSE: Starke Depression herrscht bei 8.9% der Patienten in der Gruppe mit langjähriger Erkrankung vor, im Vergleich zu 3.1% in der Gruppe ohne langjährige Erkrankung. Starke Depression tritt nach sechs Monaten bei 2.7% in der Gruppe mit langjähriger Erkrankung und bei 0.9% in der Gruppe ohne langjährige Erkrankung auf. Bei Patienten mit langjähriger Erkrankung in der ersten Etappe war die Wahrscheinlichkeit für starke Depression nach sechs Monaten viermal so hoch wie bei Patienten, die über keine langjährige Erkrankung in der ersten Etappe berichteten. SCHLUSSFOLGERUNG: Die Zusammenhänge zwischen langjähriger Erkrankung und Depression sind im Rahmen der medizinischen Grundversorgung wichtig.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Wright A. Depression. In: Pullen I, Wilkinson G, Wright A, Pereira Gray D (eds) Psychiatry and General Practice Today. Royal College of Psychiatrists & Royal College of General Practitioners, London; 1994. pp 93–111Google Scholar
  2. King M, Nazareth I, Levy G, Walker C, Morris R, Weich S, et al. Prevalence of common mental disorders in general practice attendees across Europe. Br J Psychiatry 2008;192(5): 362–7CrossRefPubMedGoogle Scholar
  3. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997; 349(9064):1498–504CrossRefPubMedGoogle Scholar
  4. Druss BG, Hwang I, Petukhova M, Sampson NA, Wang PS, Kessler RC. Impairment in role functioning in mental and chronic medical disorders in the United States: results from the National Comorbidity Survey Replication. Mol Psychiatry 2009;14(7):728–37CrossRefPubMedPubMedCentralGoogle Scholar
  5. Rost K, Zhang M, Fortney J, Smith J, Coyne J, Smith GR Jr. Persistently poor outcomes of undetected major depression in primary care. Gen Hosp Psychiatry 1998; 20(1):12–20CrossRefPubMedGoogle Scholar
  6. Katon WJ. Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biol Psychiatry 2003; 54(3):216–26CrossRefPubMedGoogle Scholar
  7. Hoffman C, Rice D, Sung HY. Persons with chronic conditions. Their prevalence and costs. JAMA 1996; 276(18):1473–9CrossRefPubMedGoogle Scholar
  8. Patten SB. Long-term medical conditions and major depression in a Canadian population study at waves 1 and 2. J Affect Disord 2001;63(1–3):35–41CrossRefPubMedGoogle Scholar
  9. Benton T, Staab J, Evans DL. Medical co-morbidity in depressive disorders. Ann Clin Psychiatry 2007;19(4):289–303CrossRefPubMedGoogle Scholar
  10. Wells KB, Golding JM, Burnham MA. Psychiatric disorder in a sample of the general population with and without medical disorder. Am J Psychiatry 1988;145:976–81CrossRefPubMedGoogle Scholar
  11. Ormel J, Von Korff M, Ustun TB, Pini S, Korten A, Oldehinkel T. Common mental disorders and disability across cultures. Results from the WHO Collaborative Study on Psychological Problems in General Health Care. JAMA 1994;272(22):1741–8CrossRefPubMedGoogle Scholar
  12. Anderson RJ, Freedland KE, Clouse RE, Lustman PJ. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001;24(6):1069–78CrossRefPubMedGoogle Scholar
  13. Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry 2001;158(5):725–30CrossRefPubMedGoogle Scholar
  14. Dickens C, McGowan L, Clark-Carter D, Creed F. Depression in rheumatoid arthritis: a systematic review of the literature with meta-analysis. Psychosom Med 2002;64(1):52–60CrossRefPubMedGoogle Scholar
  15. Car J, Kersnik J, Švab I, Rotar-Pavlič D. Detection and management of depression in Slovene family practice. A case vignette study. Zdrav Var 2006;45:90–5Google Scholar
  16. Ormel J, Rijsdij KF, Sullivan M, Van Sonderan E, Kempen G. Temporal and reciprocal relationship between IADL (ADL disability) and depressive symptoms in late life. J Gerontol B Psycho Sci Soc Sc 2002;57:338–47CrossRefGoogle Scholar
  17. van den Brink RH, Ormel J, Tiemens BG, Smit A, Jenner JA, van der Meer K, et al. Predictability of the one-year course of depression and generalized anxiety in primary care. Gen Hosp Psychiatry. 2002;24(3):156–63CrossRefPubMedGoogle Scholar
  18. King M, Weich S, Torres-González F, Švab I, Maaroos HI, Neeleman J, et al. Prediction of depression in European general practice attendees: the PREDICT study. BMC Public Health 2006;12(6):6CrossRefGoogle Scholar
  19. Rifel J, Švab I, Ster MP, Pavlic DR, King M, Nazareth I. Impact of demographic factors on recognition of persons with depression and anxiety in primary care in Slovenia. BMC Psychiatry 2008;24(8):96CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Janez Rifel
    • 1
  • Igor Švab
    • 1
  • Danica Rotar Pavlič
    • 1
  • Michael King
    • 2
  • Irwin Nazareth
    • 3
  1. 1.Department of Family Medicine, Medical FacultyUniversity in LjubljanaLjubljanaSlovenia
  2. 2.Department of Mental Health Sciences, Royal Free and University College Medical SchoolUniversity College LondonLondonUK
  3. 3.General Practice Research FrameworkUniversity College London, Rowland Hill StreetLondonUK

Personalised recommendations