Add or depression anxiety
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Anxiety and Depression in Primary Care and General Practice
Screening for Anxiety and Depression in Primary Care
Primary care providers are increasingly responsible for identifying and managing mental health conditions, including anxiety and depression. A study validated a brief screening tool, the Anxiety and Depression Detector (ADD), which effectively identifies patients with these disorders. The ADD consists of five items with high sensitivity (0.92 to 0.96) and moderate specificity (0.57 to 0.82), making it a useful tool for primary care settings 1.
Clinical Manifestations and Comorbidity
Anxiety and depressive disorders (ADD) are prevalent in both the general population and outpatient settings. These disorders often present with polysystemic somatic symptoms and frequently co-occur with cardiovascular diseases. Understanding the pathophysiology and clinical manifestations of ADD is crucial for accurate diagnosis and effective treatment 2.
Psychometric Tools for Assessing Anxiety and Depression
The Anxiety Depression Distress Inventory-27 (ADDI-27) is a short form of the Mood and Anxiety Symptom Questionnaire-90 (MASQ-90). It includes three scales: Positive Affect, Somatic Anxiety, and General Distress. Studies have shown that the ADDI-27 has strong psychometric properties, including reliability and validity, and is invariant across gender, making it a robust tool for assessing anxiety and depression 34.
Comorbidity with Attention Deficit Disorder
Children of parents with panic disorder or major depressive disorder have higher rates of attention deficit disorder (ADD). This comorbidity suggests that children referred for ADD evaluation should also be assessed for primary anxiety or depressive disorders, as these conditions frequently co-occur 5.
Social Support and Mental Health
Social support plays a significant role in mitigating symptoms of anxiety and depression. In a Canadian study, social support was negatively associated with generalized anxiety disorder (GAD) and major depressive episodes (MDEs) in both adults with and without ADD/ADHD. This indicates that social support is a protective factor against these mental health conditions 6.
Anxiety and Depression Among Healthcare Professionals
Healthcare professionals (HCPs) experience high rates of anxiety and depression due to job-related stress. A study found that 20% of HCPs had depression and 31% had anxiety, with a significant association between these conditions and excessive daytime sleepiness. Addressing mental health in HCPs is essential for their well-being and job performance 7.
Impact on Disability and Work Impairment
Anxiety and depressive disorders (ADD) significantly contribute to disability and work impairment, often more so than chronic somatic diseases (CSDs). The comorbidity of ADD and CSDs exacerbates these effects, leading to higher rates of absenteeism and reduced work performance. This highlights the need for comprehensive management of both mental and physical health conditions 8.
Anxious Depression: A Specific Clinical Form
Anxious depression, where anxiety is a symptom within a depressive episode, has distinct neurobiological mechanisms and clinical presentations. It includes various forms of anxiety, such as psychic, somatic, and motor anxiety. This subtype of depression requires specific therapeutic approaches, including psychotherapy and SSRIs, to address its unique characteristics and improve prognosis 9.
Quality of Life and Comorbid Conditions
The presence of anxiety and depressive disorders (ADD) alongside chronic medical conditions significantly worsens quality of life (QOL). Individuals with both ADD and medical comorbidities experience greater impairment in both physical and mental health components of QOL. This underscores the importance of integrated care approaches to improve overall health outcomes 10.
Conclusion
Anxiety and depressive disorders are prevalent and impactful conditions that require effective screening, diagnosis, and management in both primary care and specialized settings. Tools like the ADD and ADDI-27, along with comprehensive care strategies, are essential for addressing these mental health challenges and improving patient outcomes.
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Most relevant research papers on this topic
Using five questions to screen for five common mental disorders in primary care: diagnostic accuracy of the Anxiety and Depression Detector.
The Anxiety and Depression Detector (ADD) is a useful screening tool for identifying anxiety and depressive disorders in primary care settings.
Observational Study
Highly CitedThe Anxiety Depression Distress Inventory–27 (ADDI–27): New Evidence of Factor Structure, Item-Level Measurement Invariance, and Validity
The ADDI-27 has a 3-factor model, is invariant across gender, and shows convergent and discriminant validity of scores on its scales.
Observational StudyThe Anxiety Depression Distress Inventory-27 (ADDI-27): a short version of the Mood and Anxiety Symptom Questionnaire-90.
The ADDI-27 is a content valid, reliable, and multidimensional measure of the tripartite model of affect, assessing positive affect, somatic anxiety, and general distress.
Observational StudyAttention deficit disorder in children at risk for anxiety and depression.
Children with parents with anxiety or depressive disorders have a higher prevalence of attention deficit disorder, suggesting that primary anxiety or depressive disorders should be considered in ADD evaluations.
Observational StudyPerceived Social Support on the Relationship Between ADD/ADHD and Both Anxious and Depressive Symptoms Among Canadian Adults
Social support may be a protective factor against anxiety and depression in both adults with and without ADHD in Canada.
Observational Study
Rigorous JournalAnxiety and depressive disorders Screening among Healthcare Professionals
Anxiety and depressive disorders are prevalent in healthcare professionals, with sleepiness disorder being a significant association, but night or day shift work is not statistically correlated with ADD.
Impact of Anxiety and/or Depressive Disorders and Chronic Somatic Diseases on disability and work impairment.
Anxiety and depressive disorders have a greater impact on disability and work impairment than chronic somatic diseases, and their comorbidity worsens disability outcomes.
Observational StudyRigorous JournalAnxiety in depression
Anxious depression has specific neurobiological, prognostic, and therapeutic characteristics, requiring psychotherapeutic, sociotherapeutic, and antidepressant treatment.
Systematic ReviewRigorous JournalAnxiety and depression, chronic physical conditions, and quality of life in an urban population sample study
Anxiety disorders and depression worsen quality of life when combined with medical co-morbidities, highlighting the need for targeted interventions for better outcomes.
Observational Study