Estimated costs of neurotic disorder in UK general practice 1985

Croft-Jeffreys, Caroline; Wilkinson, Greg

doi:10.1017/s0033291700024132

Cited by 75 publications

(21 citation statements)

References 28 publications

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“…7 The total annual cost of these disorders in the UK may amount to £6 billion, of which two thirds is attributable to lost productivity. 16 One study found that the prevalence of these conditions may have increased in recent years. 17 Although they are most prevalent among those with the lowest material standard of living, 3 6 18-22 inconsistencies have been reported in the association between common mental disorders and occupational social class.…”

mentioning

confidence: 99%

Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain

Weich

Lewis

1998

Journal of Epidemiology & Community Health

168

119

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Study objective-To test the hypothesis that poor material standard of living is independently associated with the prevalence of the common mental disorders after adjusting for occupational social class, and to estimate the population impact of poor material standard of living on the prevalence of these disorders. Design-Cross sectional survey. Prevalence of the common mental disorders was assessed using the General Health Questionnaire, a self administered measure of psychiatric morbidity. Participants-9064 adults aged 16-75 living in private households in England, Wales, and Scotland. Main results-The common mental disorders were significantly associated with poor material standard of living, including low household income (OR 1.24, 95% CI 1.00, 1.54) and not saving from income (OR 1.29, 95% CI 1.15, 1.45), after adjusting for occupational social class and other potential confounders. An independent association was also found with occupational social class of the head of household among women, but not men, after adjusting for material standard of living. The adjusted population attributable fraction for poor material standard of living (using a five item index) was 24.0%. Conclusions-Like mortality and physical morbidity, common mental disorders are associated with a poor material standard of living, independent of occupational social class. These findings support the view that recent widening of inequalities in material standards of living in the United Kingdom pose a substantial threat to health.

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confidence: 99%

Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain

Weich

Lewis

1998

Journal of Epidemiology & Community Health

168

119

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“…In effetti, i costi sostenuti nel 1985 in Gran Bretagna per i disturbi nevrotici trattati esclusivamente nei servizi di medicina generale sono risultati simili a quelli richiesti da un altro disturbo molto frequente tra i pazienti del medico di base, cioe l'ipertensione arteriosa, ed ammontavano a circa il 9% delle spese complessive sostenute in quell'anno dal governo inglese per i servizi di medicina generale. Tuttavia, mentre per i pazienti ipertesi gran parte dei costi erano imputabili ai farmaci impiegati per il trattamento, per i disturbi nevrotici si trattava soprattutto di costi indiretti legati alia perdita di produttivita in campo lavorativo (Croft-Jeffreys & Wilkinson, 1989). …”

Section: Questi Risultati Suggeriscono Che I Disturbi Psichiciunclassified

Lo studio internazionale multicentrico dell'Organizzazione Mondiale della Sanità sui disturbi psichici nella medicina generale: risultati relativi all'area di Verona

Piccinelli

Pini

Bellantuono

et al. 1995

Epidemiol Psichiatr Soc

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Riassunto.Obiettivi -Presentare i risultati emersi dalla valutazione trasversale di un campione di soggetti selezionato negli ambulatori di medicina generale dell'area di Verona nel corso dello studio internazionale multicentrico dell'Organizzazione Mondiale della Sanita sui disturbi psichici nella medicina generale. Metodo -Tra coloro che si erano rivolti consecutivamente agli ambulatori di 16 medici di base nel periodo aprile 1991/febbraio 1992, e stato selezionato un campione randomizzato di soggetti, stratificato sulla base del punteggio riportato al GHQ-12, da sottoporre ad un'approfondita valutazione dello stato psicopatologico, dello stato di salute fisica e dei livelli di disability in campo occupazionale e nelle altre attivita quotidiane. Tutti i pazienti che alia valutazione iniziale presentavano sintomi psicopatologici ed un campione di soggetti pari al 20% di coloro che non presentavano sintomi psicopatologici sono stati rivalutati a distanza di 3 mesi e poi ancora di un anno (dati non presentati in questa sede). Risultati -In totale, dei 1.656 soggetti contattati dai ricercatori negli ambulatori di medicina generale, 1.625 soddisfacevano i requisiti richiesti per essere inclusi nello studio. La procedura di screening e stata completata da 1.558 soggetti e la valutazione del secondo stadio da 250. Disturbi psichici secondo i criteri dell'ICD-10 erano presenti nel 12.4% dei soggetti che avevano contattato consecutivamente gli ambulatori di medicina generale e, di questi, un terzo circa (4.5% dei soggetti sottoposti inizialmente a screening) soddisfaceva i criteri diagnostici per la presenza contemporanea di due o piu disturbi psichici diversi. Le diagnosi di Episodio Depressivo Attuale (4.7%) e quella di Sindrome Ansiosa Generalizzata (3.7%) sono risultatele piu frequenti. Un ulteriore 11.2% dei soggetti selezionati presentava disturbi psichici 'sotto la soglia' (cosi definiti sulla base della presenza di sintomi in almeno due aree sintomatologiche distinte tra quelle previste dalle singole categorie diagnostiche delFICD-10, senza che venissero perd soddisfatti tutti i criteri diagnostici per la presenza del disturbo in esame). I disturbi psichici sono risultati piu frequenti tra le donne e nella classe di eta compresa tra 25 e 44 anni. Solamente il 20.6% dei soggetti con

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“…[27j Several studies have shown that anxious patients use emergency rooms and other healthcare services at increased rate s. [28][29][30] Familial and so cia l dy sfunction , financial dependency, economic loss as a re sult of impaired ability to work and the perception of poor physical health are direct correlates of anxiety disorders. When not adequately diagnosed or treated, the annual costs of medical consultations and diagnostic tests for elderly anxious patients are up to 10 times higher than tho se for nonanxious patients.…”

Section: General Practice Settingmentioning

confidence: 99%

Anxiety in Elderly Patients

Steinberg

1994

Drugs & Aging

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The onset of primary generalised anxiety or other anxiety disorders during old age is unusual. However, these disorders are often chronic and may persist into old age, so that their occurrence in the elderly population is not rare. Secondary anxiety is also very common and may be related to endogenous stimuli, such as concomitant medical illness, or exogenous events such as loss of friends, change in life status or financial concerns. As the elderly constitute the most rapidly growing segment of the population of many developed nations, this is a problem of significant proportion. Anxiety disorders cause considerable morbidity and dysfunction and have even been shown to increase mortality rates. Nonetheless, the disorders are readily diagnosable if symptoms are properly interpreted. Failure to do so, dramatically and unnecessarily inflates healthcare costs. Certain presentations are more typical in the elderly. For example, somatisation and generalised anxiety are more common, and panic disorder is seen less often, in elderly than in younger patients. Once diagnosed, both nondrug and drug interventions may be effective. Benzodiazepines, although well recognised as useful, have been excessively criticised in terms of general use in the past. Extreme caution is warranted when these agents are used in geriatric patients as they may exacerbate cognitive impairment and cause psychomotor effects that may lead to adverse events and outcomes. Newer agents, such as the azapirones, have a lag-time to onset of action and require patient education for efficient use. They are, however, very effective in elderly patients and have been shown to be remarkably free of dangerous adverse effects. They have a very favourable risk to benefit profile in the elderly. Proper selection of therapeutic intervention allows clinicians to relieve symptoms with minimal risk of adverse effects in elderly patients.

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Estimated costs of neurotic disorder in UK general practice 1985

Cited by 75 publications

References 28 publications

Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain

Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain

Lo studio internazionale multicentrico dell'Organizzazione Mondiale della Sanità sui disturbi psichici nella medicina generale: risultati relativi all'area di Verona

Anxiety in Elderly Patients

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