Prevalence, nature, and comorbidity of depressive disorders in primary care

Coyne, James C.; Fechner-Bates, Suzanne; Schwenk, Thomas L.

doi:10.1016/0163-8343(94)90006-x

Cited by 270 publications

(172 citation statements)

References 38 publications

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“…Our estimates even surpassed depression rates among outpatient medical samples, which generally fall around 17% to 24% and are widely recognized to be much higher than community rates. [16][17][18] Nevertheless, screening positive for depression is not equivalent to being diagnosed with a major depressive episode. Even screening instruments with laudable test characteristics such as the HANDS, which has a sensitivity of 95% and a specificity of 94% for detecting a DSM-IV-diagnosed major depressive episode, 12 can yield high false positives.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Study of Depression Among Adult Patients in an Urban Emergency Department

Boudreaux¹,

Cagande²,

Kilgannon³

et al. 2006

Prim. Care Companion CNS Disord.

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Objective:To determine prevalence and predictors of depression among emergency department (ED) patients.Method: For 1 week in November 2003, consecutive adult patients presenting to an urban ED from 8:00 a.m. to midnight were screened for a DSM-IV major depressive episode using the Harvard Department of Psychiatry National Depression Screening Day Scale. Patients who were severely ill or who had altered mental status were excluded. Demographic factors, psychiatric history, and brief medical history also were assessed.Results: Of 182 patients enrolled, 57 (32%, 95% CI = 25 to 39) screened positive for depression, which was much greater than general community estimates (6.6%, p < .0001). Depression was more likely (p < .001) in patients with a psychiatric history (61% vs. 22%), substance abuse history (65% vs. 30%), or a suicide attempt (67% vs. 30%). Eleven percent (95% CI = 7 to 17) of subjects endorsed suicidal ideation at least "some of the time."Limitations: This sample underrepresented severely ill, acutely distressed, or cognitively disabled patients. The most likely effect of these exclusion criteria was to yield an underestimate of depression. Also, the ED was located in a northeastern, urban city, which may not represent the rest of the country. Finally, we used a screening instrument without established operating characteristics within the ED setting.Conclusion: Although findings suggest that depression is common, it is often ignored in the ED setting. Recent efforts to increase awareness of depression in outpatient medical settings may be warranted in EDs as well.(Prim Care Companion J Clin Psychiatry 2006;8:66-70)

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Section: Discussionmentioning

confidence: 99%

A Prospective Study of Depression Among Adult Patients in an Urban Emergency Department

Boudreaux¹,

Cagande²,

Kilgannon³

et al. 2006

Prim. Care Companion CNS Disord.

View full text Add to dashboard Cite

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“…In subtype models of PTSD, substance abuse has typically been conceptualized as characteristic of the externalizing subtype (Miller et al, , 2008, and previous studies forcing a two-factor model of broad adult psychopathology have found alcohol and drug problems to be associated with the externalizing factor (Hopwood & Moser, 2011;Ruiz & Edens, 2008). Yet, substance abuse is common among individuals with PTSD (Jacobsen, Southwick, & Kosten, 2001) as well as among those suffering from characteristically "internalizing" disorders such as depression and anxiety (Coyne, Fechner-Bates, & Schwenk, 1994;Najt, Fusar-Poli, & Brambilla, 2011). A recent examination of the latent structure of comorbidity in combat veterans identified substance-related disorders as cross-loading on both the externalizing and internalizing dimensions (Miller et al, 2008).…”

Section: Va Author Manuscriptmentioning

confidence: 99%

Personality Assessment Inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression

Voorhees

Dennis

Elbogen

et al. 2014

Aggressive Behavior

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Posttraumatic stress disorder (PTSD) is associated with aggressive behavior in veterans, and difficulty controlling aggressive urges has been identified as a primary postdeployment readjustment concern. Yet only a fraction of veterans with PTSD commit violent acts. The goals of this study were to (1) examine the higher-order factor structure of Personality Assessment Inventory (PAI) scales in a sample of U.S. military veterans seeking treatment for PTSD; and (2) to evaluate the incremental validity of higher-order latent factors of the PAI over PTSD symptom severity in modeling aggression. The study sample included male U.S. Vietnam (n = 433) and Iraq/Afghanistan (n = 165) veterans who were seeking treatment for PTSD at an outpatient Veterans Affairs (VA) clinic. Measures included the Clinician Administered PTSD Scale, the PAI, and the Conflict Tactics Scale. The sample was randomly split into two equal subsamples (n's = 299) to allow for cross-validation of statistically derived factors. Parallel analysis, variable clustering analysis, and confirmatory factor analyses were used to evaluate the factor structure, and regression was used to examine the association of factor scores with self-reports of aggression over the past year. Three factors were identified: internalizing, externalizing, and substance abuse. Externalizing explained unique variance in aggression beyond PTSD symptom severity and demographic factors, while internalizing and substance abuse did not. Service era was unrelated to reports of aggression. The constructs of internalizing versus externalizing dimensions of PTSD may have utility in identifying characteristics of combat veterans in the greatest need of treatment to help manage aggressive urges.

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“…The estimated prevalence of depressive disorders is 13-22% in primary care clinics but is only recognized in approximately 50% of cases. [4] Since many symptoms of depression overlap with those present in CKD due to uremia, many patients remain undiagnosed by the treating physician. Anxiety in CKD patients often co-occur with depression and even seem to aggravate the depressive symptoms and impaired quality of life.…”

mentioning

confidence: 99%

Prevalence of Depression, Anxiety and Insomnia in Chronic Kidney Disease Patients and their Co-Relation with the Demographic Variables

Aggarwal

Jain

Dabas

et al. 2017

Prilozi

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Background: Chronic kidney disease (CKD) is an emerging health problem in both developed and developing countries. Depression, anxiety and sleep disturbances are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patients' health. Assessment of key components of mental health early in disease course will help to identify high risk subjects in whom modifying these predictors will help in providing active and healthy life in CKD patients. Methods: We did a cross sectional study in 200 patients of CKD stage III to V-D fulfilling the eligibility criteria who were on follow up in a single tertiary care center in the state of Haryana, India. We assessed the prevalence of anxiety, depression and insomnia and their correlation with demographic variables in these patients. The structured questionnaire used in this study gathered information on respondent demographic and disease characteristics, and information obtained from the HADS and PSQI questionnaire. Factors associated with anxiety, depression and insomnia were examined by a multiple logistic regression analysis. results: The prevalence of anxiety, depression and insomnia were found to be 71%, 69% and 86.5% respectively. As the CKD stage advanced, the prevalence as well as severity of these parameters increased. Anxiety, depression and sleep quality were found to be significantly correlated to unemployment, low income, low education, urban residence and presence of co-morbidities. The anxiety, depression and insomnia scores were found to have a strong negative correlation with eGFR, hemoglobin, serum calcium (p <0.01) and a positive correlation with TLC, blood urea, serum creatinine and serum phosphate (p <0.05). conclusion: We observed a high prevalence of anxiety, depression and insomnia in CKD patients. There is a need to develop strategies to accurately identify "high risk" subjects who may benefit from preventive measures before complications occur. By identifying CKD patients with high risk of developing these mental health related issues, healthcare provider may be better able to ensure the provision of appropriate rehabilitation to this population.

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Prevalence, nature, and comorbidity of depressive disorders in primary care

Cited by 270 publications

References 38 publications

A Prospective Study of Depression Among Adult Patients in an Urban Emergency Department

A Prospective Study of Depression Among Adult Patients in an Urban Emergency Department

Personality Assessment Inventory internalizing and externalizing structure in veterans with posttraumatic stress disorder: Associations with aggression

Prevalence of Depression, Anxiety and Insomnia in Chronic Kidney Disease Patients and their Co-Relation with the Demographic Variables

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