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Background: The purpose was to test the effectiveness of two transdiagnostic group interventions compared to care as usual (CAU) for patients with anxiety, depressive or stress-related disorders within a primary health care context., Objectives: To compare the effects of cognitive-based-behavioural therapy (CBT) and multimodal intervention (MMI) on the quality of life and relief of psychological symptoms of patients with common mental disorders or problems attending primary health care centre., Methods: Patients (n = 278), aged 18-65 years, were referred to the study by the GPs and 245 were randomized to CAU or one of two group interventions in addition to CAU: (i) group CBT administered by psychologists and (ii) group MMI administered by assistant nurses. The primary outcome measure was the Mental Component Summary score of short form 36. Secondary outcome measures were Perceived Stress Scale and Self-Rating Scale for Affective Syndromes. The data were analysed using intention-to-treat with a linear mixed model., Results: On the primary outcome measure, the mean improvement based on mixed model analyses across post- and follow-up assessment was significantly larger for the MMI group than for the CBT (4.0; P = 0.020) and CAU (7.5; P = .001) groups. Participants receiving CBT were significantly more improved than those in the CAU group. On four of the secondary outcome measures, the MMI group was significantly more improved than the CBT and CAU groups. The course of improvement did not differ between the CBT group and the CAU group on these measures., Conclusions: Transdiagnostic group treatment can be effective for patients with common mental disorders when delivered in a primary care setting. The group format and transdiagnostic approach fit well with the requirements of primary care., (© The Author 2014. Published by Oxford University Press.)

Background: Data regarding mortality among depressed patients in Swedish primary care is limited., Objectives: We compared mortality in a cohort of depressed and non-depressed patients at long-term follow-up and compared these values with standardized mortality rates (SMRs) in the Swedish population. Hazards ratios (HRs) for the relationship between death and depression, psychosocial factors and lifestyle were analysed, and we explored the proportion of unnatural causes of deaths., Methods: Mortality was studied in a cohort of 124 depressed and 280 non-depressed patients 12 years after being diagnosed with depression in primary care. Mortality and the mortality rates and SMRs in depressed and non-depressed patients were compared by gender. Cox regression was applied to calculate HRs for the risk of dying for explanatory variables, including depression, psychosocial factors and lifestyle., Results: A larger number of depressed patients, 11% (n = 14), compared with non-depressed patients, 4% (n = 12), died (P = 0.008), with significantly higher values among depressed men (P = 0.014). SMRs did not differ from those of the Swedish population. Depression was the only variable associated with a significantly elevated risk of death (HR, 3.34; 95% CI, 1.38-8.08). Nearly one-third of deaths had unnatural causes when alcohol-related deaths were included., Conclusion: This study underlines the importance of careful follow-up of all depressed patients' mental and physical health and the intervention on unhealthy lifestyles. Large primary care database studies are needed to explore the association between depression, co-morbid somatic diseases, lifestyle and mortality.