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

TitleDiagnostic consequences of a new category of anxious depression and a reduced duration requirement for anxiety symptoms in the ICD-11 PHC
Authors
KeywordsAnxiety
Depression
Primary care
ICD-11
Classification
Issue Date2019
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jad
Citation
Journal of Affective Disorders, 2019, v. 245, p. 120-125 How to Cite?
AbstractBackground: 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. Methods: 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. Results: 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. Limitations: The study was not designed to establish prevalence of these conditions. Conclusion: 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.
Persistent Identifierhttp://hdl.handle.net/10722/266365
ISSN
2023 Impact Factor: 4.9
2023 SCImago Journal Rankings: 2.082
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorZiebold, C-
dc.contributor.authorMari, JJ-
dc.contributor.authorGoldberg, DP-
dc.contributor.authorMinhas, F-
dc.contributor.authorRazzaque, B-
dc.contributor.authorFortes, S-
dc.contributor.authorRobles, R-
dc.contributor.authorLam, TP-
dc.contributor.authorBobes, J-
dc.contributor.authorIglesias, C-
dc.contributor.authorGarcía, JÁ-
dc.contributor.authorReed, GM-
dc.date.accessioned2019-01-18T08:18:06Z-
dc.date.available2019-01-18T08:18:06Z-
dc.date.issued2019-
dc.identifier.citationJournal of Affective Disorders, 2019, v. 245, p. 120-125-
dc.identifier.issn0165-0327-
dc.identifier.urihttp://hdl.handle.net/10722/266365-
dc.description.abstractBackground: 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. Methods: 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. Results: 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. Limitations: The study was not designed to establish prevalence of these conditions. Conclusion: 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.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jad-
dc.relation.ispartofJournal of Affective Disorders-
dc.subjectAnxiety-
dc.subjectDepression-
dc.subjectPrimary care-
dc.subjectICD-11-
dc.subjectClassification-
dc.titleDiagnostic consequences of a new category of anxious depression and a reduced duration requirement for anxiety symptoms in the ICD-11 PHC-
dc.typeArticle-
dc.identifier.emailLam, TP: tplam@hku.hk-
dc.identifier.authorityLam, TP=rp00386-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jad.2018.10.082-
dc.identifier.pmid30368071-
dc.identifier.scopuseid_2-s2.0-85055347064-
dc.identifier.hkuros296702-
dc.identifier.volume245-
dc.identifier.spage120-
dc.identifier.epage125-
dc.identifier.isiWOS:000456697100014-
dc.publisher.placeNetherlands-
dc.identifier.issnl0165-0327-

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