Depressive and Anxiety Disorders in Patients Presenting With Physical Complaints

Kroenke, Kurt; Jackson, Jeffrey L.; Chamberlin, J.

doi:10.1016/s0002-9343(97)00241-6

Cited by 270 publications

(203 citation statements)

References 42 publications

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“…Interestingly, consistent with the literature on rates of depression among patients with chronic illness (Eaton, 2002;Frasure-Smith, Lesperance, & Talajic, 1993;Kroenke et al, 1997), 64.4% of patients scoring 15 or over had at least one comorbid medical condition (47.7% for those scoring 10-14, and 31.9% for those scoring under 10). Those indicating major depression were also assessed for other psychiatric diagnoses (PCPs and patients completed this assessment for 77% of patients scoring in the major depression range) and we have found very high rates of comorbid anxiety, panic, and histories of childhood and adult abuse (see Table 2).…”

Section: The Depression In Primary Care Interventionsupporting

confidence: 83%

“…In general, patients with chronic conditions prefer to receive services in primary care (Wagner, Austin, & VonKorff, 1996). However, patients in primary care with depression and other mental health disorders are more likely to have unmet expectations about their medical care, and providers are more likely to find them frustrating patients to care for (Kroenke, Jackson, & Chamberlin, 1997).…”

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confidence: 99%

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Crossing The Divide: Primary Care And Mental Health Integration

Upshur

2005

Adm Policy Ment Health

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This paper describes the views of primary care providers about treating depression among adult Medicaid patients and their experiences with managed behavioral health care. It also shows the outcomes of an intervention project that provides a care manager to facilitate connections among PCPs, patients, and behavioral health providers. Despite widespread initiatives to improve depression management in primary care and to manage behavioral health services, it appears that links between the two systems and the use of evidence-based approaches to managing patients are rare. A pilot project to initiate practice redesign, the use of a care manager to assist in patient support, and compliance with both medical and behavioral health treatment has been shown to improve communication and results in positive patient outcomes. Managed behavioral health care can result in incentive structures that create gaps between primary care and behavioral health systems. This project illustrates an initiative co-sponsored by the Massachusetts behavioral health program designed to strengthen links between behavioral health and primary care, and increase rates and effectiveness of depression treatment.KEY WORDS: depression; managed behavioral health; Medicaid; primary health care.

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Section: The Depression In Primary Care Interventionsupporting

confidence: 83%

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confidence: 99%

Crossing The Divide: Primary Care And Mental Health Integration

Upshur

2005

Adm Policy Ment Health

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“…Analyses were conducted using SAS 9.1. 24 A two-sided p-value <0.05 was considered statistically significant for reporting associations.…”

Section: Discussionmentioning

confidence: 99%

Depression and Anxiety Diagnoses Are Not Associated with Delayed Resolution of Abnormal Mammograms and Pap Tests Among Vulnerable Women

et al. 2011

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BACKGROUND: Delays in care after abnormal cancer screening contribute to disparities in cancer outcomes. Women with psychiatric disorders are less likely to receive cancer screening and may also have delays in diagnostic resolution after an abnormal screening test. OBJECTIVE: To determine if depression and anxiety are associated with delays in resolution after abnormal mammograms and Pap tests in a vulnerable population of urban women. DESIGN: We conducted retrospective chart reviews of electronic medical records to identify women who had a diagnosis of depression or anxiety in the year prior to the abnormal mammogram or Pap test. We used timeto-event analysis to analyze the outcome of time to resolution after abnormal cancer screening, and Cox proportional hazards regression modeling to control for confounding. PARTICIPANTS: Women receiving care in six Bostonarea community health centers 2004-2005: 523 with abnormal mammograms, 474 with abnormal Pap tests. RESULTS: Of the women with abnormal mammogram and pap tests, 19% and 16%, respectively, had comorbid depression. There was no difference in time to diagnostic resolution between depressed and not-depressed women for those with abnormal mammograms (aHR=0.9, 95 CI 0.7,1.1) or Pap tests (aHR=0.9, 95 CI 0.7,1.3). CONCLUSIONS: An active diagnosis of depression and/ or anxiety in the year prior to an abnormal mammogram or Pap test was not associated with a prolonged time to diagnostic resolution. Our findings imply that documented mood disorders do not identify an additional barrier to resolution after abnormal cancer screening in a vulnerable population of women.KEY WORDS: depression; cancer screening; women's health; minority populations.

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“…Not only patients and primary care physicians' factors, but also the waxing and waning nature of GAD, leading to a "discrepancy" between primary reasons for visiting the GPs and actual diagnosis is important for recognizing GAD accurately (Ansseau et al, 2004;Tylee & Walters, 2007). Chronic nature of GAD with remissions and recurrences, symptoms do not meet the criteria in periods of recovery between episodes and substantial overlap with other medical and psychological disorders may make it difficult to easily detect it (Kroenke et al, 1997, RoyByrne Wagner, 2004Allgulander, 2006). Major depressive disorder is seen in at least onethird of primary care patients with GAD (Carter et al, 2001;Stein, 2003).…”

Section: Presentation and Recognition Of Gad In Primary Carementioning

confidence: 99%

Challenges and Opportunities in Diagnosis and Management of Generalized Anxiety Disorder in Primary Care

Kartal¹

2011

Anxiety and Related Disorders

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Depressive and Anxiety Disorders in Patients Presenting With Physical Complaints

Cited by 270 publications

References 42 publications

Crossing The Divide: Primary Care And Mental Health Integration

Crossing The Divide: Primary Care And Mental Health Integration

Depression and Anxiety Diagnoses Are Not Associated with Delayed Resolution of Abnormal Mammograms and Pap Tests Among Vulnerable Women

Challenges and Opportunities in Diagnosis and Management of Generalized Anxiety Disorder in Primary Care

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