Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T22:26:06.835Z Has data issue: false hasContentIssue false

Chronic depression and anxiety in primary care: approaches to liaison

Published online by Cambridge University Press:  02 January 2018

Rights & Permissions [Opens in a new window]

Extract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Much attention has focused on prompt, accurate identification and treatment of depression and anxiety in primary care settings. Less is known about what to do when treatment is unsuccessful or the initial opportunity to intervene is missed. The long-term prognosis of depression and anxiety in primary care settings is not good: half of sufferers experience a relapsing remitting course and a quarter become chronic. There is also a relationship between chronicity and high service utilisation. The label “heartsink” has sometimes been applied to these patients, often pejoratively.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 1995 

References

Bass, C. (1994) Somatisation. In Prevention in Psychiatry (eds Paykel, E. & Jenkins, R.) pp 188197. London: Gaskell.Google Scholar
Corney, R. (1984) The effectiveness of attached social workers in the management of depressed female patients in general practice. Psychological Medicine, 14 (Monograph Suppl. 6.), 147.Google Scholar
Corney, R. & Murray, J. (1988) The characteristics of high and low attenders at two general practices. Social Psychiatry & Psychiatric Epidemiology, 23, 3949.CrossRefGoogle ScholarPubMed
Creed, F. & Marks, B. (1989) Liaison psychiatry in general practice: a comparison of the liaison attachment scheme and the shifted out-patient clinic models. Journal of the Royal College of General Practitioners, 39, 514517.Google Scholar
Department of Health (1994) Health of the Nation Key Area Handbook of Mental Illness (2nd edn), pp 1924. London: HMSO.Google Scholar
Drummond, L.M. (1994) Anxiety. In Psychiatry and General Practice Today (eds Pullen, I., Wilkinson, G., Wright, A. et al), pp 112134. London: Gaskell.Google Scholar
Eisenberg, L. (1992) Treating depression and anxiety in primary care: closing the gap between knowledge and practice. New England Journal of Medicine, 326, 10801084.CrossRefGoogle ScholarPubMed
Freemantle, N., Long, N., Mason, J. et al (1993) The treatment of depression in primary care. Effectiveness Health Care Bulletin, 5, 212.Google Scholar
Gask, L. (1992) Teaching psychiatric interview skills to general practitioners. In Prevention of Depression and Anxiety – the Role of the Primary Care Team (eds Jenkins, R., Newton, J. & Young, J.) pp 3945. London: HMSO.Google Scholar
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders. London: Routledge.Google Scholar
Goldberg, D. (1994) Epidemiology of mental disorder in general practice. In Psychiatry and General Practice Today (eds Pullen, I., Wilkinson, G., Wright, A. et al), pp 3644. London: Gaskell.Google Scholar
Gournay, K. & Brooking, J. (1994) Community psychiatric nurses in primary health care. British Journal of Psychiatry, 165, 231238.Google Scholar
Jenkins, R. (1992) Depression and anxiety: an overview of preventive strategies. In Prevention of Depression and Anxiety – the Role of the Primary Care Team (eds Jenkins, R., Newton, J. & Young, R.) pp 1121. London: HMSO.Google Scholar
Johnstone, A. & Goldberg, D. (1976) Psychiatric screening in general practice: a controlled trial. Lancet, i, 605608.Google Scholar
Kendrick, T., Sibbald, P., Burns, T. et al (1991) Role of general practitioners in care of long-term mentally ill. British Medical Journal, 302, 508510.CrossRefGoogle ScholarPubMed
King, M. & Pullen, I. (1994) Communication between general practitioners and psychiatrists. In Psychiatry and General Practice Today (eds Pullen, I., Wilkinson, G., Wright, A. et al), pp 251264. London: Gaskell.Google Scholar
Lloyd, K. & Jenkins, R. (1994) Primary Care. In Prevention in Psychiatry (eds Paykel, E. & Jenkins, R.) pp 198209. London: Gaskell.Google Scholar
Lloyd, K. & Jenkins, R. (1995) The economics of depression in primary care: Department of Health Initiatives. British Journal of Psychiatry, 166 (Suppl. 27), 6062.Google Scholar
Lyons, R.A., Caroli, D., Doherty, K. et al (1992) General practice estimates of the prevalence of common chronic conditions. Irish Medical Journal, 85, 2224.Google Scholar
Mann, A. H., Jenkins, R. & Belsey, E. (1981) The 12 month outcome of patients with neurotic disorder in general practice. Psychological Medicine, 11, 535550.CrossRefGoogle Scholar
Mynors-Wallis, L.M. & Gath, D.H. (1992) Brief psychological treatments. International Review of Psychiatry, 4, 301306.Google Scholar
Paykel, E. S. & Priest, R. G. (1992) Recognition and management of depression and general practice: consensus statement. British Medical Journal, 305, 11981202.Google Scholar
Robson, M. (1992) Counselling in general practice: options for action. A clinical psychology. In Prevention of Depression and Anxiety – the Role of the Primary Care Team (eds Jenkins, R., Newton, J. & Young, R.) pp 7781. London: HMSO.Google Scholar
Scott, J., Eccleston, D. & Boys, R. (1992) Can we predict the persistence of depression? British Journal of Psychiatry, 161, 633637.Google Scholar
Sharp, D. & Morrell, D. (1989) The psychiatry of general practice. In Scientific Approaches in Epidemiological Psychiatry. Essays in Honour of Michael Shepherd (eds Williams, P., Wilkinson, G. & Rawnsley, K.) pp 404419. London: Routledge.Google Scholar
Sims, A. (1973) Mortality and neurosis. Lancet, ii, 10721075.Google Scholar
Strathdee, G. (1994) Psychiatry and general practice – a psychiatric perspective. In Psychiatry and General Practice Today (eds Pullen, I., Wilkinson, G., Wright, A. et al), pp 2235. London: Gaskell.Google Scholar
Tyrer, P. (1984) Psychiatric clinics in general practice: an extension of community care. British Journal of Psychiatry, 145, 914.Google Scholar
Tyrer, P. (1994) Personality disorder. In Psychiatry and General Practice Today (eds Pullen, I., Wilkinson, G., Wright, A. et al), pp 180193. London: Gaskell.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.