Deciding who gets treatment for depression and anxiety: a study of consecutive GP attenders

Most research has focused on recognition by GPs of the common mental disorders: depression and anxiety. However, less is known about the factors that determine whether patients with those disorders that are recognised receive any active treatment. To investigate factors associated with receiving act...

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Bibliographic Details
Published in:British journal of general practice 2005-11, Vol.55 (520), p.846-853
Main Authors: Hyde, Julia, Evans, Jonathan, Sharp, Debbie, Croudace, Tim, Harrison, Glynn, Lewis, Glyn, Araya, Ricardo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Anxiety Disorders - therapy
Attitude of Health Personnel
Decision Making
Depressive Disorder - therapy
Family Practice - statistics & numerical data
Female
Health Services Needs and Demand - statistics & numerical data
Humans
Male
Middle Aged
Original Papers
Practice Guidelines as Topic
Practice Patterns, Physicians' - statistics & numerical data
Severity of Illness Index
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Summary:Most research has focused on recognition by GPs of the common mental disorders: depression and anxiety. However, less is known about the factors that determine whether patients with those disorders that are recognised receive any active treatment. To investigate factors associated with receiving active treatment among consecutive attenders identified by GPs as having a common mental disorder. Data were collected as part of a cluster randomised controlled trial in 30 general practices in the south of Bristol, UK, on the impact of mental health guidelines in primary care. We studied 439 consecutive general practice attenders aged 16-64 years who were given a diagnosis of depression, anxiety, or chronic mixed anxiety and depression by their GP. The main outcome measure was the provision of any active treatment, whether pharmacological or psychological, for these disorders. Patient, GP, and practice level data, including sociodemographic, clinical, and administrative data were explored as predictors in a logistic regression model. Huber White variance estimates were used to account for hierarchical clustering. Of those patients identified as having a common mental disorder by the GP, 54% were offered active treatment. Higher symptom score, as measured by the General Health Questionnaire (GHQ) (odds ratio [OR] = 1.09; 95% confidence interval [CI] = 1.06 to 1.13; P
ISSN:0960-1643