Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-09T17:00:49.361Z Has data issue: false hasContentIssue false

7 - Depression and anxiety

from Part I - Health promotion

Published online by Cambridge University Press:  21 August 2009

Anne Walling
Affiliation:
University of Kansas, Wichita
Jo Ann Rosenfeld
Affiliation:
The Johns Hopkins University
Get access

Summary

Case: “I am turning into a big fat lump that just lies around eating, sleeping and feeling sorry for myself all the time!” This sudden outburst during a visit for a “routine pap smear” is completely out of character for Marie, a 44-year-old divorced schoolteacher who is usually smartly groomed, articulate, and vivacious. Tactful questioning reveals about a four-week history of excessive sleeping and feelings of fatigue, low stamina, and worthlessness. She has been snacking excessively and has gained about six pounds. Marie admits to severe “blues” during her freshman college year and after the births of her children, but she “toughed it out.” This time, she does not have the energy or will to continue her daily activities and she has called in sick for the first time ever as she “just could not face doing a mediocre job for the class.”

Introduction and epidemiology

Up to 30% of women seen in primary care clinics suffer from a depressive illness, compared with an estimated 19% of male patients. In the general population, approximately one-quarter of all women but only 10% of men suffer from depression at any time during the lifespan. This gender difference begins in adolescence and continues until the sixth decade. As individuals, women generally carry a greater burden of illness in depression than men. Depression is more likely to begin at an earlier age in women and to follow a pattern with more severe, chronic, and recurrent illness with greater functional impairment and more comorbid conditions than in male patients.

Type
Chapter
Information
Women's Health in Mid-Life
A Primary Care Guide
, pp. 97 - 122
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Olfson, M., Shea, S., Feder, A., et al.Prevalence of anxiety, depression, and substance abuse disorders in an urban general medicine practice. Arch. Fam. Med. 2000; 9:876–83CrossRefGoogle Scholar
Williams, J. B., Spitzer, R. L., Linzer, M., et al.Gender differences in depression in primary care. Am. J. Obstet. Gynecol. 1995; 173:654–9CrossRefGoogle ScholarPubMed
Kessler, R. C., McGonagle, K. A., Swartz, M., et al.Sex and depression in the National Comorbidity Survey. I: lifetime prevalence, chronicity, and recurrence. J. Affect. Disord. 1993; 29:85–96CrossRefGoogle ScholarPubMed
Fava, M., Abraham, M., Alpert, J., et al.Gender differences in axis I comorbidity among depressed patients. J. Affect. Disord. 1996; 38:129–33CrossRefGoogle Scholar
Kornstein, S. G.Gender differences in depression: implications for treatment. J. Clin. Psychiatry 1997; 58:S12–18Google ScholarPubMed
Choby, B. A. Midlife Care of Women. Monograph no. 278. Leawood, KS: American Academy of Family Physicians; 2002
Sorenson, S. B. and Golding, J. M.Depressive sequelae of recent criminal victimization. J. Trauma. Stress 1990; 3:337–50CrossRefGoogle Scholar
Tylee, A., Gastpar, M., Lepine, J. P. and Mendlewicz, J.Identification of depressed patients in the community and their treatment needs: findings from the DEPRES II (Depression Research in European Society II) survey. Int. Clin. Psychopharmacol. 1999; 14:153–65Google Scholar
Kornstein, S. G., Schatzberg, A. F., Thase, M. E., et al.Gender differences in chronic major and double depression. J. Affect. Disord. 2000; 60:1–11CrossRefGoogle ScholarPubMed
Pignone, M. P., Gaynes, B. N., Rushton, J. L., et al.Screening for depression in adults: a summary of the evidence for the US Preventive Services Task Force. Ann. Intern. Med. 2002; 136:765–76CrossRefGoogle Scholar
Brody, D. S., Hahn, S. R., Spitzer, R. L., et al.Identifying patients with depression in the primary care setting: a more efficient method. Arch. Intern. Med. 1998; 158:2469–77CrossRefGoogle ScholarPubMed
Williams, J. W., Noel, P. H., Cordes, J. A., Ramirez, G. and Pigone, M.Is this patient clinically depressed?J. Am. Med. Assoc. 2002; 287:1160–70CrossRefGoogle ScholarPubMed
Richter, P., Werner, J., Heerlein, A., et al.On the validity of the Beck Depression Inventory: a review. Psychopathology 1998; 31:160–68CrossRefGoogle ScholarPubMed
Beck, A. T., Guth, D., Steer, R. A. and Ball, R.Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary care. Behav. Res. Ther. 1997; 35:785–91CrossRefGoogle ScholarPubMed
Pignone, M. P., Gaynes, B. N., Rushten, J. L., et al.Screening for depression in adults: a summary of the evidence for the US Preventive Services Task Force. Ann. Intern. Med. 2002; 136:765–76CrossRefGoogle Scholar
Moscicki, E. K.Identification of suicide risk factors using epidemiologic studies. Psychiatr. Clin. North Am. 1997; 20:499–517CrossRefGoogle ScholarPubMed
National Guidelines Clearinghouse. Practice guideline for psychiatric evaluation of adults. http://www.guideline.gov/summary/summary.aspx?doc_id=1407. Accessed July 2002
Pajer, K.New strategies in the treatment of depression in women. J. Clin. Psychiatry 1995; 56:30–37Google ScholarPubMed
Person, J. B., Thase, M. E. and Crits-Christop, P.The role of psychotherapy in the treatment of depression.; review of two practice guidelines. Arch. Gen. Psychiatry 1996; 53:283–90CrossRefGoogle Scholar
Olfson, M., Marcus, S. C., Druss, B., Elinson, L., Tanielian, T. and Pincus, H. A.National trends in the outpatient treatment of depression. J. Am. Med. Assoc. 2002; 287:203–9CrossRefGoogle ScholarPubMed
Simon, G.Choosing a first-line antidepressant: equal on average does not mean equal for everyone. J. Am. Med. Assoc. 2001; 286:3003–3004CrossRefGoogle Scholar
Preskorn, S. Outpatient Management of Depression: a Guide for the Primary Care Practitioner, 2nd edition. Caddo, OK: Professional Communications; 1999
Thase, M. E., Rush, J. and Howland, R. H.Double blind switch study of imipramine or sertraline treatment of antidepressant-resistant chronic depression. Arch. Gen. Psychiatry. 2002; 59:233–9CrossRefGoogle ScholarPubMed
Kroenke, K., West, S. L., Swindle, R., et al.Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial. J. Am. Med. Assoc. 2001; 286:2947–55CrossRefGoogle ScholarPubMed
Ereshefsky, L., Riesenman, C. and Lam, Y. W.Serotonin selective reuptake inhibitor drug interactions and the cytochrome P450 system. J. Clin. Psychiatry 1996; 57:17–24Google ScholarPubMed
Manber, R., Allen, J. J. B. and Morris, M. M.Alternative treatments for depression: empirical support and relevance to women. J. Clin. Psychiatry 2002; 63:628–40CrossRefGoogle ScholarPubMed
Hypericum Depression Trial Study Group. Effect of Hypericum perforatum (St. John's Wort) in major depressive disorder. J. Am. Med. Assoc. 2002; 287:1807–14CrossRef
Endicott, J.History, evolution, and diagnosis of premenstrual dysphoric disorder. J. Clin. Psychiatry 2000; 61:5–8Google ScholarPubMed
Steiner, M., Romano, S. J., Babcock, S., et al.The efficacy of fluoxetine in improving physical symptoms associated with premenstrual dysphoric disorder. Br. J. Obstet. Gynaecol. 2001; 108:462–8Google ScholarPubMed
Yonkers, K. A., Halbreich, U., Freeman, E., et al.Symptomatic improvement of premenstrual dysphoric disorder with sertraline treatment. A randomized controlled trial. J. Am. Med. Assoc. 1997; 278:983–8CrossRefGoogle ScholarPubMed
Pearlstein, T. and Stone, A. B.Premenstrual syndrome. Psychiatr. Clin. North Am. 1998; 21:577–90CrossRefGoogle ScholarPubMed
Freeman, E. W., Rickels, K., Sondheimer, S. J. and Polansky, M.Differential response to antidepressants in women with premenstrual syndrome/premenstrual dysphoric disorder: a randomized controlled trial. Arch. Gen. Psychiatry 1999; 56:932–9CrossRefGoogle ScholarPubMed
Cohen, L. S., Miner, C., Brown, E., Freeman, E. W., Halbreich, U. and Sundell, K.Premenstrual daily fluoxetine for premenstrual dysphoric disorder: a placebo-controlled clinical trial using computerized diaries. Obstet. Gynecol. 2002; 100: 435–44Google ScholarPubMed
Hamblin, J. E. and Schifeling, D. J. Cancer Survivors. Monograph no. 264. Leawood, KS: American Academy of Family Physicians; 2001
Marsh, C. M.Psychiatric presentations of medical illness. Psychiatr. Clin. North. Am. 1997; 20:181–204CrossRefGoogle ScholarPubMed
Moscato, B. S., Russell, M. and Sielezny, M.Gender differences in the relation between depressive symptoms and alcohol problems: a longitudinal perspective. Am. J. Epidemiol. 1997; 146:966–74CrossRefGoogle ScholarPubMed
Nutt, D. J.The pharmacology of human anxiety. Pharmacol. Ther. 1990; 47:233–66CrossRefGoogle ScholarPubMed
Kessler, R. C., McGonagle, K. A. and Shanyang, Z.Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch. Gen. Psychiatry 1994; 51:8–19CrossRefGoogle ScholarPubMed
Pigott, T. A.Gender differences in the epidemiology and treatment of anxiety disorders. J. Clin. Psychiatry 1999; 60(supp 18):4–15Google ScholarPubMed
Skaer, T. L., Robison, L. M., Sclar, D. A. and Galin, R. S.Anxiety disorders in the USA, 1990–1997 – trend in complaint, diagnosis, use of pharmacotherapy and diagnosis of comorbid depression. Clin. Drug Invest. 2000; 20:237–44Google Scholar
DuPont, R. L., Rice, D. R. and Miller, L. S.Economic costs of anxiety disorders. Anxiety 1996; 2:167–723.0.CO;2-L>CrossRefGoogle ScholarPubMed
Simon, G., Ormel, J., VonKorff, M. and Barlow, W.Health care costs associated with depressive and anxiety disorders in primary care. Am. J. Psychiatry 1995; 152:352–7Google ScholarPubMed
Baughman, O. L.Rapid diagnosis and treatment of anxiety and depression in primary care: the somatizing patient. J. Fam. Pract. 1994; 39:373–8Google ScholarPubMed
Ballenger, J. C., Davidson, J. R. T. and Lecrubier, Y.Consensus statement on generalized anxiety disorder from the international consensus group on depression and anxiety. J. Clin. Psychiatry 2001; 62(supp 11):53–8Google ScholarPubMed
Blazer, D. G., Kessler, R. C., McGonagle, K. and Swartz, M. S.The prevalence and distribution of major depression in a community sample: the national comorbidity survey. Am. J. Psychiatry 1994; 151:979–86Google Scholar
Wittchen, H., Zhao, S., Kessler, R. C. and Eaton, W. W.DSM-III-R generalized anxiety disorder in the national comorbidity survey. Arch. Gen. Psychiatry 1994; 51:355–64CrossRefGoogle ScholarPubMed
Yonkers, K. A., Warshaw, M. G., Massion, A. O. and Keller, M. B.Phenomenology and course of generalized anxiety disorder. Br. J. Psychiatry 1996; 168:308–13CrossRefGoogle Scholar
Robins, L. N., Helzer, J. E. and Weissman, M. M.Lifetime prevalence of specific psychiatric disorders in three sites. Arch. Gen. Psychiatry 1984; 41:949–58CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Washington, DC: American Psychiatric Association; 1994
Nemeroff, C. B. and Schatzberg, A. F. Recognition and Treatment of Psychiatric Disorders. Washington, DC: American Psychiatric Press; 1999
Bisserbe, J. C., Weiller, E., Boyer, P., Lepine, J. P. and Lecrubier, Y.Social phobia in primary care: level of recognition and drug use. Int. Clin. Psychopharmacol. 1996; 11(supp 3):25–8CrossRefGoogle ScholarPubMed
Foa, E. B.Trauma and women: course, predictors, and treatment. J. Clin. Psychiatry 1997; 58(supp 9):25–8Google Scholar
Weissman, M. M., Bland, R. C. and Canino, G. J.The cross-national epidemiology of panic disorder. Arch. Gen. Psychiatry 1997; 54:305–9CrossRefGoogle ScholarPubMed
Marshall, J. R.Comorbidity and its effects on panic disorder. Bull. Menninger Clin. 1996; 60: A39–53Google ScholarPubMed
Yonkers, K. A., Zlotnick, C. and Allsworth, J.Is the course of panic disorder the same in women and men?Am. J. Psychiatry 1998; 155:596–602CrossRefGoogle ScholarPubMed
Dick, C. L., Bland, R. C. and Newman, S. C.Panic disorder. Acta Psychiatr. Scand. Suppl. 1994; 376:45–53CrossRefGoogle ScholarPubMed
Goldberg, R. J.Diagnostic dilemmas presented by patients with anxiety and depression. Am. J. Med. 1995; 98:278–84CrossRefGoogle ScholarPubMed
House, A. and Stark, D.Anxiety in medical patients. Br. Med. J. 2002; 325:207–9CrossRefGoogle ScholarPubMed
Rakel, R. E.Anxiety and the primary care physician. Prim. Psychiatry 2001; 8:52–8Google Scholar
Sartorius, N., Ustun, T. B., Lecrubier, Y. and Wittchen, H. U.Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care. Br. J. Psychiatry 1996; 168(supp 30):38–43Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×