Outcomes for depression and anxiety in primary care and details of treatment: A naturalistic longitudinal study
Open accessAbstract
BACKGROUND: There is little evidence as to whether or not guideline concordant care in general practice results in better clinical outcomes for people with anxiety and depression. This study aims to determine possible associations between guideline concordant care and clinical outcomes in general practice patients with depression and anxiety, and identify patient and treatment characteristics associated with clinical improvement. METHODS: This study forms part of the Netherlands Study of Depression and Anxiety (NESDA).Adult patients, recruited in general practice (67 GPs), were interviewed to assess DSM-IV diagnoses during baseline assessment of NESDA, and also completed questionnaires measuring symptom severity, received care, socio-demographic variables and social support both at baseline and 12 months later. The definition of guideline adherence was based on an algorithm on care received. Information on guideline adherence was obtained from GP medical records. RESULTS: 721 patients with a current (6-month recency) anxiety or depressive disorder participated. While patients who received guideline concordant care (N=281) suffered from more severe symptoms than patients who received non-guideline concordant care (N=440), both groups showed equal improvement in their depressive or anxiety symptoms after 12 months. Patients who (still) had moderate or severe symptoms at follow-up, were more often unemployed, had smaller personal networks and more severe depressive symptoms at baseline than patients with mild symptoms at follow-up. The particular type of treatment followed made no difference to clinical outcomes. CONCLUSION: The added value of guideline concordant care could not be demonstrated in this study. Symptom severity, employment status, social support and comorbidity of anxiety and depression all play a role in poor clinical outcomes.
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Low social support is associated with poor physical and mental health.
“Low social support is a key factor related to serious negative health outcomes, including poor physical and mental health, increased mortality risk, and suicidal ideation and behavior [1,2,3,4].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [3]
The Results (Patient characteristics and course of anxiety and depression) associate smaller personal networks with persistent moderate or severe anxiety or depressive symptoms, although the association disappeared after adjustment for baseline symptom severity. The paper supports a relationship with these mental-health outcomes, but the supplied passages do not address physical health. (LLM, conf=0.88)
Experimental — accuracy not yet measuredLow social support is associated with suicidal ideation and behavior.
“Low social support is a key factor related to serious negative health outcomes, including poor physical and mental health, increased mortality risk, and suicidal ideation and behavior [1,2,3,4].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [3]
The Results (Patient characteristics and course of anxiety and depression; page unavailable) link smaller personal networks with persistent depressive or anxiety symptoms, not suicidal ideation or behavior. Searches for “suicidal ideation and behavior” and “suicide social support” found no passage in our copy addressing the claimed association. (LLM, conf=0.76)
Experimental — accuracy not yet measuredLow social support is associated with increased mortality risk.
“Low social support is a key factor related to serious negative health outcomes, including poor physical and mental health, increased mortality risk, and suicidal ideation and behavior [1,2,3,4].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [3]
The Results section (Patient characteristics and course of anxiety and depression; page unavailable) associates smaller personal networks with persistent anxiety or depressive symptoms, not mortality. The Methods section (Clinical outcome measures; page unavailable) identifies symptom severity as the measured outcome. Searches for social support and mortality, and for death or survival, found no passage addressing mortality risk. (LLM, conf=0.77)
Experimental — accuracy not yet measuredVeterans with PTSD are a population at high risk of mortality and other negative outcomes.
“a population at high risk of mortality and other negative outcomes [1,2,3,4].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [3]
The Results and Discussion address symptom outcomes among primary-care patients with anxiety or depression, not mortality among veterans with PTSD. Searches for veterans, PTSD, and mortality found no passage in our copy addressing the attributed claim. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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- Authors
- Prins, M. A., Verhaak, P. F., Hilbink-Smolders, M., Spreeuwenberg, P., Laurant, M. G., van der Meer, K., van Marwijk, H. W., Penninx, B. W., & Bensing, J. M.
- Affiliations
- Netherlands Institute for Health Services Research (NL)
- University Medical Center Groningen (NL)
- Radboud University Medical Center (NL)
- Utrecht University (NL)
- Corresponding author
- Verhaak, Peter FM
- Venue
- BMC Psychiatry
- Published
- 2011-11-18
- Volume
- 11
- Issue
- 1
- Pages
- 180-180
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC3288826
- OpenAlex
- W2166534855
- Semantic Scholar
- c4d3bd75fbea9da04c457f1644d76c6329ff4c44
- Cited by
- 28
- References
- 52
- Citations by year
- 2022: 2 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 5 · 2013: 2 · 2012: 1
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Research Explorer (The University of Manchester) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- VU Research Portal (submittedVersion, other-oa)
- Funders
- Universiteit Leiden
- ZonMw
- Vrije Universiteit Amsterdam
- GGZ inGeest
- Rivierduinen
- GGZ Friesland
- GGZ Drenthe
- Nederlands Instituut voor Onderzoek van de Gezondheidszorg
- Leids Universitair Medisch Centrum
- Universitair Medisch Centrum Groningen
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- depression, anxiety, guideline-concordant care, primary care, clinical outcomes, symptom severity, social support, employment status, comorbidities, treatment characteristics, general practice, NESDA
- MeSH terms
- Adult, Anxiety Disorders, Depressive Disorder, Female, Humans, Longitudinal Studies, Male, Middle Aged, Netherlands, Primary Health Care, Surveys and Questionnaires, Treatment Outcome, Practice Guidelines as Topic, Guideline Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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