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Depression/Anxiety

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Handbook of Outpatient Medicine

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Abstract

Depression is the most common psychiatric disease worldwide in the general population with the lifetime risk being 13.23% (95% confidence interval, 12.64–13.81) [1]. It is almost twice as common in women as compared to men and more common in developed countries than the developing world [1, 2]. Depression is under recognized in the primary care setting as it presents with somatic symptoms (headache, back pain, chronic pain, etc.) in up to two-third of the affected patients [3]. Patients are not forthcoming about depressive symptoms unless asked directly, for various reasons including, but not limited to, fear of stigmatization, considering such symptoms to be their personal flaw rather than an illness, misconception that depressive symptoms can only be assessed by a psychiatrist, and concerns about being prescribed an antidepressant medication [4]. The comorbid state of depression with other chronic diseases incrementally worsens health when compared with depression alone, with any of the chronic diseases alone, and with any combination of chronic diseases without depression [5]. Patients with depression have an increased risk of mortality {1.81 (95% CI: 1.58–2.07)} [6].

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References

  1. Kessler RC, Ormel J, Petukhova M, et al. Development of lifetime comorbidity in the World Health Organization world mental health surveys. Arch Gen Psychiatry. 2011;68(1):90–100. https://doi.org/10.1001/archgenpsychiatry.2010.180.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005;62(10):1097.

    Article  PubMed  Google Scholar 

  3. Tylee A, Gandhi P. The importance of somatic symptoms in depression in primary care. Prim Care Companion J Clin Psychiatry. 2005;7(4):167–76.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bell RA, Franks P, Duberstein PR, et al. Suffering in silence: reasons for not disclosing depression in primary care. Ann Fam Med. 2011;9(5):439–46. https://doi.org/10.1370/afm.1277.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Moussavi S, Chatterji S, Verdes E, et al. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370(9590):851–8.

    Article  PubMed  Google Scholar 

  6. Cuijpers P, Smit F. Excess mortality in depression: a meta-analysis of community studies. J Affect Disord. 2002;72(3):227–36.

    Article  PubMed  Google Scholar 

  7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013. (DSM-5).

    Book  Google Scholar 

  8. Wittchen HU, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(9):655–79.

    Article  CAS  PubMed  Google Scholar 

  9. Smith DJ, Court H, McLean G, et al. Depression and multimorbidity: a cross-sectional study of 1,751,841 patients in primary care. J Clin Psychiatry. 2014;75(11):1202–8.

    Article  PubMed  Google Scholar 

  10. Barber C, Frank E, Demicco R. Reducing suicides through partnerships between health professionals and gun owner groups—beyond Docs vs Glocks. JAMA Intern Med. 2017;17(1):5–6. https://doi.org/10.1001/jamainternmed.2016.6712. Published online November.

    Article  Google Scholar 

  11. Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9.

    Article  PubMed  Google Scholar 

  12. Roemer L, Molina S, Borkovec TD. An investigation of worry content among generally anxious individuals. J Nerv Ment Dis. 1997;185(5):314.

    Article  CAS  PubMed  Google Scholar 

  13. Angst J, Gamma A, Baldwin DS, et al. The generalized anxiety spectrum: prevalence, onset, course and outcome. Eur Arch Psychiatry Clin Neurosci. 2009;259(1):37–45. Epub 2008 Jun 24.

    Article  PubMed  Google Scholar 

  14. Tully PJ, Cosh SM, Baune BT. A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease. Psychol Health Med. 2013;18(6):627.

    Article  PubMed  Google Scholar 

  15. Tyrer P, Seivewright H, Johnson T. The Nottingham Study of Neurotic Disorder: predictors of 12-year outcome of dysthymic, panic and generalized anxiety disorder. Psychol Med. 2004;34(8):1385–94.

    Article  PubMed  Google Scholar 

  16. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092.

    Article  PubMed  Google Scholar 

  17. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res. 2002;52(2):69–77.

    Article  PubMed  Google Scholar 

  18. Siu AL, the US Preventive Services Task Force (USPSTF). Screening for depression in adults US preventive services task force recommendation statement. JAMA. 2016;315(4):380–7.

    Article  CAS  PubMed  Google Scholar 

  19. Mitchell AJ, Yadegarfar M, Gill J, Stubbs B. Case finding and screening clinical utility of the Patient Health Questionnaire (PHQ-9 and PHQ-2) for depression in primary care: a diagnostic meta-analysis of 40 studies. BJPsych open. 2016;2(2):127–38. https://doi.org/10.1192/bjpo.bp.115.001685.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Nelson JC. Tricyclic and tetracyclic drugs. In: Schatzberg AF, Nemeroff CB, editors. The American psychiatric publishing textbook of psychopharmacology. 4th ed. Washington, DC: American Psychiatric Publishing; 2009. p. 263.

    Google Scholar 

  21. Lazare A. The interview as a clinical negotiation. In: Lipkin M, Putnam SM, Lazare A, editors. The medical interview: clinical care, education and research. New York, NY: Springer-Verlag; 1995.

    Google Scholar 

  22. Coulehan JL, Platt FW, Egener B, et al. “Let Me See If I Have This Right …”: words that help build empathy. Ann Intern Med. 2001;135:221–7. https://doi.org/10.7326/0003-4819-135-3-200108070-00022.

    Article  CAS  PubMed  Google Scholar 

  23. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.

    Article  PubMed  Google Scholar 

  24. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–92.

    Article  PubMed  Google Scholar 

  25. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Montefiore New Rochelle Hospital, 16 Guion Place, New Rochelle, NY, 10801, USA

    Daniel Pomerantz MD, MPH & Ashutosshh Naaraayan MD

Authors
  1. Daniel Pomerantz MD, MPH
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  2. Ashutosshh Naaraayan MD
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Correspondence to Daniel Pomerantz MD, MPH .

Editor information

Editors and Affiliations

  1. Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA

    Elana Sydney

  2. Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA

    Eleanor Weinstein

  3. Department of Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York, USA

    Lisa M. Rucker

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Pomerantz, D., Naaraayan, A. (2018). Depression/Anxiety. In: Sydney, E., Weinstein, E., Rucker, L. (eds) Handbook of Outpatient Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-68379-9_33

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  • DOI: https://doi.org/10.1007/978-3-319-68379-9_33

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-68378-2

  • Online ISBN: 978-3-319-68379-9

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