the course of untreated anxiety and depression, and determinants of poor one-year outcome a one-year cohort study治疗焦虑和抑郁,和穷人一年一年的队列研究结果的决定因素.pdf

van Beljouw et al. BMC Psychiatry 2010, 10:86 /1471-244X/10/86 RESEARCH ARTICLE Open Access The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study 1 1* 2 3 4,5,6 Ilse MJ van Beljouw , Peter FM Verhaak , Pim Cuijpers , Harm WJ van Marwijk , Brenda WJH Penninx Abstract Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor outcome. Method: Baseline and one-year follow-up data were used of 594 primary care patients with current anxiety or depressive disorders at baseline (established by the Composite Interview Diagnostic Instrument (CIDI)), from the Netherlands Study of Depression and Anxiety (NESDA). Receipt of and need for care were assessed by the Perceived Need for Care Questionnaire (PNCQ). Results: In depression, treated and untreated patients with a perceived treatment need showed more rapid symptom decline but greater symptom severity at follow-up than untreated patients without a self-perceived mental problem or treatment need. A lower education level, lower income, unemployment, loneliness, less social support, perceived need for care, number of somatic disorders, a comorbid anxiety and depressive disorder and symptom severity at baseline predicted a poorer outcome in both anxiety and depression. When all variables were considered at the same time, only baseline symptom severity appeared to predict a poorer outcome in anxiety. In depression, a poorer outcome was also predicted by more lonelin