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How do older patients present? What are the risk factors? What are the treatments? * EPIDEMIOLOGICAL STUDIES SUGGEST THAT ANXIETY AND DEPRESSION, AS DEFINED BY ICD-10 AND DSM-IV criteria, are [...]

What are the NICE quality statements? What are the implications for primary care? How will they improve patient management? DEPRESSION IS A COMMON DISORDER. THE 2007 HOUSEHOLD SURVEY OF ADULT [...]

How should anxiety disorder be diagnosed? How should severity be assessed? What are the evidence-based treatment options? GENERALISED ANXIETY DISORDER (GAD) IS A COMMON CONDITION, WITH A POINT PREVALENCE OF [...]

How should patients be identified? How should depression be classified? What are the management options? >> COMPARED WITH THE GENERAL POPULATION, PATIENTS WITH A CHRONIC PHYSICAL health problem are two [...]

A cross-sectional study has found an association between depression and lack of vitamin D in older people. Data were provided by the 2005 Health Survey for England, which focussed on [...]

Dr Phillip Bland GP, Dalton-in-Furness Since its introduction to the Western world by the Spanish conquistadors, chocolate has been promoted as being of medicinal value; in 1662, Cardinal Brancaccio declared [...]

Reviewer: Mental health - Dr Phillip Bland GP, Dalton-in-Furness At least one third of those suffering from depressive illness do not seek medical help. Men are less likely to seek [...]

Reviewer: Mental health - Dr Phillip Bland GP, Dalton-in-Furness Patients with severe mental illness (SMI) are at increased risk of premature death. Sixty per cent of the excess mortality in [...]

Dr Phillip Bland GP, Dalton-in-Furness It is increasingly recognised that suicide does not provide the only pathway from depression to death. Depression appears to be an independent risk factor for [...]

Reviewer: Mental health Dr Phillip Bland GP, Dalton-in-Furness It has been shown that 25-50% of our patients present with physical symptoms for which there is no satisfactory pathological explanation.1 Our [...]

Generalised anxiety disorder (GAD) is associated with a near doubling of the risk of adverse outcomes following myocardial infarction (MI), a Dutch naturalised cohort study has found. A total of [...]

An epidemiological study from UK primary care has found that adult patients prescribed oral glucocorticoids are seven times more likely to attempt suicide than untreated patients with the same medical [...]

Life review therapy is an effective intervention for adults aged 55 and older with depressive symptoms, a Dutch pragmatic randomised controlled trial has found. Participants aged 55 and above were [...]

Online messaging via an electronic medical record is an effective and efficient way of providing enhanced care for depressed patients, a primary care study from the United States has found. [...]

Following a coronary heart disease (CHD) event, group CBT reduces the risk of recurrent cardiovascular events by 41%, a randomised controlled trial from Sweden has found. A total of 362 [...]

A multiple treatments meta-analysis has found that sertraline is the best tolerated therapy for generalised anxiety disorder (GAD). There were 27 randomised controlled trials which were suitable for inclusion in [...]

A single-blind, randomised trial from the USA has found that tai chi significantly improves the health-related quality of life of patients with fibromyalgia. A total of 66 tertiary care patients [...]

Passive smoking is associated with psychological distress and the risk of developing severe psychiatric illness, a cross-sectional and longitudinal study has found. A total of 8,155 adults, of whom 2,595 [...]

A three-year historic cohort study from primary care in the Netherlands has found that one out of every seven frequent attenders continued to attend frequently in each of the following [...]

Patients with diabetes have a three-fold increased risk of progression from mild cognitive impairment to dementia, a primary care study has shown. The longitudinal cohort study recruited 103 participants aged [...]

Individuals with a high intake of vegetables, fruit and fish have a lowered risk of depression, an analysis from a large, prospective cohort study has found. Conversely, those who consumed [...]

A primary care study has found that only 1% of patients in high-risk groups who were invited for screening received treatment for major depression as a result. A prospective cohort [...]

The two-year mortality risk for CHD patients is more than doubled if they have symptoms of depression. (1) A prospective cohort study from California has found that the association between [...]

Children who are the victims of bullying are more likely to experience psychiatric problems as young adults, an American prospective population-based cohort study has found. A total of 1,420 children [...]

SCREENING FOR DEPRESSION IN PATIENTS WITH CORONARY HEART DISEASE OR DIABETES DOES significantly increase the number of patients with recognised depression, but the absolute number is so small that it [...]

Babies of women with bipolar disorder are more likely to be born preterm, irrespective of whether the mother had received mood stabilising drugs, a Swedish cohort study has found. Infants [...]

ADDITION OF CBT TO ANTIDEPRESSANT DRUG THERAPY MORE THAN TREBLES THE ODDS OF response for those with treatment-resistant depression, a primary care study has found. (1) Overall 469 patients aged [...]

Older patients who start taking benzodiazepines have a 50% increased risk of developing dementia, a French prospective cohort study has found. The PAQUID cohort is a community sample of people [...]

MANY DOCTORS STILL HOLD ON TO THE TRADITIONAL BELIEFS THAT THEY SHOULD BE infallible and invincible, that they should not become ill, and that they should not let colleagues and [...]

Adults with severe to profound deafness suffer from high levels of psychological distress, and experience difficulties in accessing health care, a review has found. Relevant studies published since 2005 were [...]

Patients who are prescribed citalopram or nortriptyline are at increased risk of sudden cardiac death, a Danish study has found. A total of 19,110 patients who had suffered a cardiac [...]

Depression in adults is not improved by the addition of individual exercise therapy to standard care, a pragmatic randomised controlled trial from the UK has found. A total of 361 [...]

THE AIMS OF PALLIATIVE CARE ARE TO PROVIDE THE BEST QUALITY OF LIFE FOR PATIENTS AND THEIR families, and to facilitate a good death. The NICE quality standard on end [...]

A meta-analysis of studies comparing the symptom profiles of younger and older patients with major depression has found that older people are more likely to present with agitation, somatic symptoms [...]

PATIENTS WITH MODERATELY SEVERE OR SEVERE ALZHEIMER'S DISEASE BENERT FROM CONTINUED treatment with donepezil, a UK study published in the New England Journal of Medicine, has found. (1) Patients who [...]

A comparative study using data from the US Food and Drug Administration (FDA) has found that the risk of depression and suicidal/self-harm behaviour is substantially greater with varenicline than with [...]

A population-based cohort study from the Nordic countries has found that women who take SSRIs during the second half of pregnancy are more than twice as likely to give birth [...]

A cross-sectional, postal survey of GPs has found worryingly high levels of burnout. The study revealed high scores for emotional exhaustion and depersonalisation in more than four out of ten [...]

Individual music therapy improves outcomes in depression when combined with standard therapy, a randomised controlled trial from Finland has found. A total of 79 participants (62 women), aged 18 to [...]

A CROSS-SECTIONAL STUDY USING DATA FROM THE 2007 HOUSEHOLD SURVEY IN ENGLAND HAS FOUND a strong association between work stress and common mental health disorders, which is independent of the [...]

A large cohort study from the UK has reached the surprising conclusion that tricyclics are the safest class of antidepressants in elderly people. The cohort comprised 60,746 primary care patients [...]

A significant minority of depressed patients have unrecognised bipolar disorder, a primary care study from Wales has found. Patients were eligible to participate if they had a recorded diagnosis of [...]

COMPARED WITH THOSE WITH NEITHER CONDITION, WOMEN WITH BOTH DIABETES AND DEPRESSION are more than twice as likely to die from all causes, and nearly three times as likely to [...]

Antidepressants are a safe and effective treatment for depression in patients with a chronic physical illness, a NICE systematic review and meta-analysis has concluded. A total of 63 studies involving [...]

Antidepressants are no more effective than placebo as a treatment for patients with subthreshold depression, a meta-analysis has found. Six double-blind randomised controlled trials met the inclusion criteria. There was [...]

COLLABORATIVE CARE IMPROVES DEPRESSION OUTCOMES AND CHRONIC DISEASE CONTROL IN patients with depression and poorly controlled diabetes and/or CHD, an American primary care study has found. (1) Moreover, patients had [...]

Patients who have undergone bariatric surgery are at substantially increased risk of suicide, a study from the United States has found. Although the absolute suicide rate (1 in 538) was [...]

PATIENTS WITH DEPRESSION ARE MORE LIKELY TO DIE. THE STRONGEST EVIDENCE LINKS DEPRESSION with cardiac mortality (cardiac SMR 1.5-2.0), but there is also growing evidence of an increase in all [...]

An observational study from the UK has assessed the relative toxicity of 14 antidepressants. As in previous studies, (1,2) tricyclics were found to be much more toxic in overdose than [...]

A nested case-control study has found an association between current use of SSRIs/venlafaxine and cataracts. The cohort comprised residents of Quebec aged [greater than or equal to] 65 years who [...]