The twelve-month outcome of patients with neurotic illness in general practice.

Abstract

One hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. Standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year. The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness characterized by a rapid recovery after the initial assessment. Patients who reported continuous psychiatric morbidity during the year were older, physically ill and very likely to have received psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression. The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatric disorders, with symptoms, personality and social state being rated independently.