Year-end Sale % OFF 
Abstract
ObjectivesDepression is a common illness with substantial economic consequences for society and a great burden for affected individuals. About 30% of patients with depression do not respond to repeated treatments. Psychiatric comorbidity is known to affect duration, recurrence and treatment outcome of depression. However, there is a lack of knowledge on the extent to which psychiatric comorbidity is identified in the clinical setting for depressed patients in secondary psychiatric care. Therefore, the aim of this study was to compare the agreement between traditional diagnostic assessment (TDA) and a structured and comprehensive diagnostic procedure (SCDP) for identification of personality and anxiety disorder comorbidity in depressed patients in secondary psychiatric care.Methods274 patients aged 18–77 were referred from four secondary psychiatric care clinics in Sweden during 2012–2017. ICD-10 diagnoses according to TDA (mostly unstructured by psychiatric specialist and residents in psychiatry), were retrieved from medical records and compared to diagnoses resulting from the SCDP in the study. This included the Mini International Neuropsychiatric Interview, the Structured Interview for DSM Axis II Personality Disorders and semi-structured questions on psychosocial circumstances, life-events, psychiatric symptoms, psychiatric treatments, substance use, and suicidal and self-harm behaviour. The assessment was carried out by psychiatric specialists or by residents in psychiatry with at least three years of psychiatric training.ResultsSCDP identified personality disorder comorbidity in 43% of the patients compared to 11% in TDA (p<0,0001). Anxiety disorder comorbidity was identified in 58% with SCDP compared to 12% with TDA (p<0,0001).ConclusionsImportant psychiatric comorbidity seems to be unrecognized in depressive patients when using TDA, which is routine in secondary psychiatric care. Comorbidities are better identified using the proposed model involving structured and semi-structured interviews together with clinical evaluations by clinical experts.
Highlights
Depression is a common illness, affecting nearly 300 million people around the world [1], and is often associated with severe suffering and significant dysfunctions in important areas of life
International Classification of Diseases 10th revision (ICD-10) diagnoses according to traditional diagnostic assessment (TDA), were retrieved from medical records and compared to diagnoses resulting from the structured and comprehensive diagnostic procedure (SCDP) in the study
SCDP identified personality disorder comorbidity in 43% of the patients compared to 11% in TDA (p
Summary
Depression is a common illness, affecting nearly 300 million people around the world [1], and is often associated with severe suffering and significant dysfunctions in important areas of life. Treatment resistance is common in depression and is associated with an even more malignant disease course with psychological impairments, poorer occupational outcomes and a higher suicide risk [4]. Less than one third of depressed patients respond to the first line of treatment, and subsequent treatment attempts result in approximately one third of patients not achieving remission [5, 6]. In Sweden, the majority of patients with depression are seen in primary care by general practitioners [7]. Depressed patients who do not achieve remission in primary care, are often referred by their general practitioner to secondary psychiatric care
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
