Details

Autor(en) / Beteiligte

• Ziebold, Carolina
• Mari, Jair J.
• Goldberg, David P.
• Minhas, Fareed
• Razzaque, Bushra
• Fortes, Sandra
• Robles, Rebeca
• Lam, Tai Pong
• Bobes, Julio
• Iglesias, Celso
• García, José Ángel
• Reed, Geoffrey M.

Titel

Diagnostic consequences of a new category of anxious depression and a reduced duration requirement for anxiety symptoms in the ICD-11 PHC

Ist Teil von

• Journal of affective disorders, 2019-02, Vol.245, p.120-125

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2019

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• •Anxious depression was more common than depression in the study sample.•Anxiety lasting less than 3 months caused as much disability than longer durations.•The frequency of suicidal ideation was independent of anxiety duration.•ICD-11 PHC can encourage the early identification of anxiety. A new diagnosis of anxious depression (AD), characterized by both depressive and anxious symptoms at case level, has been proposed for the classification of mental disorders for primary care for ICD-11 (ICD-11 PHC). The ICD-11 PHC proposes a duration requirement for anxiety symptoms of 2 weeks, in line with the requirement for depressive symptoms. This study examined diagnostic assignment under ICD-11 PHC as compared to the previous classification, the ICD-10 PHC, and the relationship of anxiety duration to disability and suicidal ideation. Primary care physicians in five countries referred patients based on either perceived psychological distress or distressing somatic symptoms to a research assistant who administered a computer-guided diagnostic interview. Complete data were obtained for 2279 participants. Under ICD-11 PHC 47.7% participants received a diagnosis of AD and had greater disability than other diagnostic groups. Under ICD-10 PHC, in addition to meeting requirements for depressive episode, most of these patients met requirements for either generalized anxiety disorder (41.5%) or mixed anxiety and depressive disorder (45.4%). One third of individuals diagnosed with AD had anxiety durations between 2 weeks and 3 months and presented as much disability and suicidal ideation as individuals with longer anxiety durations. The study was not designed to establish prevalence of these conditions. The proposed ICD-11 PHC encourages early identification and management of significant anxiety symptoms in primary care, particularly when these co-occur with depression. This study provides support for the clinical relevance of these symptoms and the importance of early identification.