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Depression in General Practice:

Clinical Features and Comparison with Out-Patients

Published online by Cambridge University Press:  29 January 2018

L. I. Sireling ,
P. Freeling ,
E. S. Paykel ,
B. M. Rao  and
S. P. Patel
L. I. Sireling
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE
P. Freeling
Affiliation:
Sub-Department of General Practice, St George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE
E. S. Paykel*
Affiliation:
St George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE
B. M. Rao
Affiliation:
Department of Psychiatry, St George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE
S. P. Patel
Affiliation:
Department of Clinical Epidemiology & Social Medicine, St George's Hospital Medical School, Cranmer Terrace, London, SW17 0RE
*
∗ Correspondence.
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Summary

General practice (GP) depressives prescribed an antidepressant were compared with those given other treatment, and with antidepressant-treated psychiatric out-patient depressives. GP depressives were considerably less severely ill than out-patients, with fewer depressive symptoms and shorter illness, as well as less primary and less endogenous depression. The two groups of GP depressives differed less, but those receiving other treatment tended to have less severe depression than those receiving antidepressants and were less likely to satisfy diagnostic criteria for depression. Depressives in GP differ considerably in clinical characteristics from psychiatric out-patient depressives, and clinical features influence the GP's decision to treat with antidepressants.

Type
Papers
Information
The British Journal of Psychiatry , Volume 147 , Issue 2 , August 1985 , pp. 119 - 126
Copyright
Copyright © 1985 The Royal College of Psychiatrists 

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References

Bebbington, P. E., Tennant, C. & Hurry, J. (1981a) Adversity and the nature of psychiatric disorder in the community. Journal of Affective Disorders, 3, 345–366.CrossRefGoogle ScholarPubMed
Bebbington, P. E., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981b) The epidemiology of mental disorders in Camberwell. Psychological Medicine, 11, 561–579.Google Scholar
Brown, G. W. & Harris, T. (1978) Social Origins of Depression: a study of psychiatric disorder in women. London: Tavistock.Google Scholar
Carney, M. W. P., Roth, M & Garside, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, 111, 659–674.CrossRefGoogle Scholar
Clare, A. W. (1981) Psychotropic drug use in general practice in Britain In Epidemiological Impact of Psychotropic Drugs (eds. Tognoni, G., Bellantuono, C. & Lader, M.). Amsterdam: Elsevier/North-Holland.Google Scholar
Cooper, B. & Sylph, J. (1973) Life events and the onset of neurotic illness: an investigation in general practice. Psychological Medicine, 3, 421–435.Google Scholar
Davies, B. & Blashki, T. (1973) Course of depression: a comparison of depression in general practice and hospital In Classification and Prediction of Outcome of Depression. Stuttgart: F. K. Schattauer.Google Scholar
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1983) Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry, 142, 247–256.Google Scholar
Dennis, P. J. (1979) Monitoring of psychotropic drug prescribing in general practice. British Medical Journal, ii, 1115–1116.Google Scholar
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35, 837–844.Google Scholar
Fahy, T. J. (1974a) Pathways of specialist referral of depressed patients from general practice. British Journal of Psychiatry, 124, 231–239.Google Scholar
Fahy, T. J. (1974b) Depression in hospital and in general practice: a direct clinical comparison. British Journal of Psychiatry, 124, 240–242.Google Scholar
Fahy, T. J. Brandon, S. & Garside, R. F. (1969) Clinical syndromes in a sample of depressed patients: a general practice material. Proceedings of the Royal Society of Medicine, 62, 331–335.Google Scholar
Finlay-Jones, R., Brown, G. W., Duncan-Jones, P., Harris, T., Murphy, E. & Prudo, R. (1980) Depression and anxiety in the community: replicating the diagnosis of a case. Psychological Medicine, 10, 445–454.Google Scholar
Finlay-Jones, R. A. & Murphy, E. (1979) Severity of psychiatric disorder and the 30-item General Health Questionnaire. British Journal of Psychiatry, 134, 609–616.Google Scholar
Freeling, P., Rao, B. M., Paykel, E. S., Sireling, L. I. & Burton, R. H. (1985) Unrecognised depression in general practice. British Medical Journal, (in press).CrossRefGoogle Scholar
Goldberg, D. P. (1972) The Detection of Psychiatric Illness by Questionnaire. Maudsley Monograph No. 21. London: Oxford University Press.Google Scholar
Goldberg, D. P. (1982) The concept of a psychiatric ‘case’ in general practice. Social Psychiatry, 17, 61–65.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970) Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal, ii, 439–443.CrossRefGoogle Scholar
Goldberg, D. P. & Huxley, P. (1980) Mental Illness in the Community. London: Tavistock.Google Scholar
Grad de Alarcon, J., Sainsbury, P. & Costain, W. R. (1975) Incidence of referred mental illness in Chichester and Salisbury. Psychological Medicine, 5, 32–54.Google Scholar
Hamilton, M. (1967) Development of a rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.Google Scholar
Hoeper, E. W., Nycz, G. R., Cleary, P. D., Regier, D. A. & Goldberg, I. D. (1979) Estimated prevalence of RDC mental disorder in primary medical care. International Journal of Mental Health, 8, 6–15.Google Scholar
Howie, J. G. R. (1972) Diagnosis—The Achilles' heel. Journal of the Royal College of General Practitioners, 22, 310–315.Google Scholar
Johnson, D. A. W. (1973) Treatment of depression in general practice. British Medical Journal, ii, 18–20.Google Scholar
Johnson, D. A. W. (1974) A study of the use of antidepressant medication in general practice. British Journal of Psychiatry, 125, 186–192.CrossRefGoogle ScholarPubMed
Johnson, D. A. W. & Mellor, V. (1977) The severity of depression in patients treated in general practice. Journal of the Royal College of General Practitioners, 27, 419–422.Google Scholar
Marks, J. N., Goldberg, D. P. & Hillier, V. F. (1979) Determinants of the ability of general practitioners to detect psychiatric illness. Psychological Medicine, 9, 337–353.Google Scholar
Nie, N. H., Hull, C. H., Jenkins, J. G., Steinbrenner, K. & Bent, D. H. (1975) Statistical Package for the Social Sciences, 2nd edition. New York; McGraw-Hill.Google Scholar
Office of Health Economics (1984) Compendium of Health Statistics. London: Office of Health Economics.Google Scholar
OPCS (1974) Morbidity Statistics from General Practice – 2nd National Study 1970–71. London: HMSO.Google Scholar
Parker, G. & Blignault, I. (1983) A comparative study of neurotic depression in symptomatic volunteers and psychiatric patients. Australian and New Zealand Journal of Psychiatry, 17, 74–81.Google Scholar
Paykel, E. S. (1985) The clinical interview for depression: development reliability and validity. Journal of Affective Disorders. In press.Google Scholar
Paykel, E. S. Klerman, G. L. & Prusoff, B. (1970) Treatment setting and clinical depression. Archives of General Psychiatry, 22, 11–21.Google Scholar
Paykel, E. S. Prusoff, B. A., Klerman, G. L. & DiMascio, A. D. (1973) Self-report and clinicians' assessment of depression. Journal of Nervous and Mental Disease, 156, 166–182.Google Scholar
Paykel, E. S. Rao, B. M. & Taylor, C. N. (1984) Life stress and symptom pattern in outpatient depression. Psychological Medicine, 14, 559–568.Google Scholar
Pilowsky, I. & Spence, N. D. (1978) Depression inside and outside the hospital setting. British Journal of Psychiatry, 132, 265–268.Google Scholar
Porter, A. M. W. (1970) Depressive illness in a general practice. A demographic study and a controlled trial of imipramine. British Medical Journal, i, 773–778.CrossRefGoogle Scholar
Raskin, A. Schulterbrandt, J. G., Reatig, N. & McKeon, J. J. (1970) Differential response to chlorpromazine, imipramine and placebo. A study of sub-groups of hospitalised depressed patients. Archives of General Psychiatry, 23, 164–173.Google Scholar
Raynes, N. V. (1979) Factors affecting the prescribing of psychotropic drugs in general practice consultations. Psychological Medicine, 9, 671–679.Google Scholar
Research Unit of the Royal College of General Practitioners (1976) Trends in national morbidity: A comparison of two successive national morbidity studies. Journal of the Royal College of General Practitioners, Occasional paper 3.Google Scholar
Rowan, P. R., Paykel, E. S. & Parker, R. R. (1982) Phenelzine and amitriptyline: effects on symptoms of neurotic depression. British Journal of Psychiatry, 140, 475–483.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. W. (1964) Minor mental illness in London: some aspects of a general practice survey. British Medical Journal, ii, 1359–1363.Google Scholar
Sireling, L. I., Paykel, E. S., Freeling, P., Rao, B. M. & Patel, S. P. (1985) Depression in general practice: case thresholds and diagnosis. British Journal of Psychiatry, 147, 113–119.CrossRefGoogle ScholarPubMed
Skegg, D. C. G., Doll, R. & Perry, J. (1977) Use of medicines in general practice. British Medical Journal, i, 1561–1563.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Thomson, J., Rankin, H., Ashcroft, G. W., Yates, C. M., McQueen, J. K. & Cummings, S. W. (1982) The treatment of depression in general practice: a comparison of L-tryptophan, amitriptyline and a combination of L-tryptophan and amitriptyline with placebo. Psychological Medicine, 12, 741–751.Google Scholar
Trethowan, W. H. (1975) Pills for personal problems. British Medical Journal, iii, 749–751.CrossRefGoogle Scholar
Tyrer, P. (1978) Drug treatment of psychiatric patients in general practice. British Medical Journal, ii, 1008–1010.Google Scholar
Watson, M. W. & Barber, J. H. (1981) Depressive illness in general practice: a pilot study. Health Bulletin (Edinburgh) 39/2, 112–116.Google Scholar
Weissman, M. W. & Myers, J. K. (1978) Affective disorders in a U.S. urban community. Archives of General Psychiatry, 35, 1304–1311.Google Scholar
Williams, P., Murray, J. & Clare, A. (1982) A longitudinal study of psychotropic drug prescription. Psychological Medicine, 12, 201–206.Google Scholar
Wing, J. K. (1976) A technique for studying psychiatric morbidity in inpatient and outpatient series and in general population samples. Psychological Medicine, 6, 665–671.Google Scholar
Wing, J. K. Cooper, J. E. & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K. Mann, S. A., Leff, J. P. & Nixon, J. M. (1978) The concept of a ‘case’ in psychiatric population surveys. Psychological Medicine, 8, 203–217.Google Scholar
Zintl-Wiegand, A. & Cooper, B. (1979) Psychiatric morbidity in general practice in a West German city In Estimating Needs for Mental Health Care: A Contribution of Epidemiology (ed. Hafner, H.). New York: Springer-Verlag.Google Scholar
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