Panic disorder in primary care: A cause of unexplained symptoms

1997 ◽  
Vol 64 (8) ◽  
pp. 437-443 ◽  
Author(s):  
D. J. MUZINA ◽  
D. A. MALONE
Keyword(s):  
Primary Care ◽  
Panic Disorder ◽  
Unexplained Symptoms

scholarly journals The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis

2021 ◽  
pp. 1-14
Author(s):  
Joshua E. J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Phoebe Barnett ◽  
Katherine Clarke ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Panic Disorder ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Antidepressant Treatment ◽  
Patient Data ◽  
History Of ◽  
Depressive Symptom Severity

Abstract Background This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care. Methods We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Results Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions. Conclusions When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.

scholarly journals Depression and panic disorder as predictors of health outcomes for patients with asthma in primary care

2008 ◽  
Vol 102 (3) ◽  
pp. 359-366 ◽  
Author(s):  
Antonius Schneider ◽  
Bernd Löwe ◽  
Franz Joachim Meyer ◽  
Kathrin Biessecker ◽  
Stefanie Joos ◽  
...  
Keyword(s):  
Primary Care ◽  
Panic Disorder ◽  
Health Outcomes

scholarly journals Exploration of DSM-IV Criteria in Primary Care Patients With Medically Unexplained Symptoms

2005 ◽  
Vol 67 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Robert C. Smith ◽  
Joseph C. Gardiner ◽  
Judith S. Lyles ◽  
Corina Sirbu ◽  
Francesca C. Dwamena ◽  
...  
Keyword(s):  
Primary Care ◽  
Medically Unexplained Symptoms ◽  
Medically Unexplained ◽  
Primary Care Patients ◽  
Unexplained Symptoms ◽  
Dsm Iv

scholarly journals New models of care: a liaison psychiatry service for medically unexplained symptoms and frequent attenders in primary care

2017 ◽  
Vol 41 (6) ◽  
pp. 340-344 ◽  
Author(s):  
Janine Bestall ◽  
Najma Siddiqi ◽  
Suzanne Heywood-Everett ◽  
Charlotte Freeman ◽  
Paul Carder ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Synthesis ◽  
Medically Unexplained Symptoms ◽  
Cost Savings ◽  
Models Of Care ◽  
Liaison Psychiatry ◽  
Long Term Conditions ◽  
Early Results ◽  
Medically Unexplained ◽  
Unexplained Symptoms

Aims and methodThis paper describes the process of setting up and the early results from a new liaison psychiatry service in primary care for people identified as frequent general practice attenders with long-term conditions or medically unexplained symptoms. Using a rapid evidence synthesis, we identified existing service models, mechanisms to identify and refer patients, and outcomes for the service. Considering this evidence, with local contingencies we defined options and resources. We agreed a model to set up a service in three diverse general practices. An evaluation explored the feasibility of the service and of collecting data for clinical, service and economic outcomes.ResultsHigh levels of patient and staff satisfaction, and reductions in the utilisation of primary and secondary healthcare, with associated cost savings are reported.Clinical implicationsA multidisciplinary liaison psychiatry service integrated in primary care is feasible and may be evaluated using routinely collected data.

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