DEPRESSION COMORBID WITH ANXIETY - RESULTS FROM THE WHO STUDY ON PSYCHOLOGICAL DISORDERS IN PRIMARY HEALTH-CARE

The World Health Organization collaborative study on ''Psychological P roblems in General Health Care'' investigated the form, frequency, cou rse and outcome of common psychological problems in primary care setti ngs at 15 international sites. The research employed a two-stage case- finding procedure. GHQ-12 was administered to 25916 adults who consult ed health-care services. The second-stage assessment (n=5438) consiste d of the Composite International Diagnostic Interview (CIDI) the Socia l Disability Schedule, and questionnaires. Possible cases or borderlin e cases of mental disorder, and a sample of known cases, were followed up at three months and one year. Using standard diagnostic algorithms (ICD-10), prevalence rates were calculated for current disorder (one, month) and lifetime experience disorder. Well-defined psychological pr oblems are frequent in all the general health-care settings examined ( median 24.0%). Among the most common were depression, anxiety, alcohol misuse, somatoform disorders, and neurasthenia. Nine pet cent of pati ents suffered from a(n) subthreshold condition ''that did not meet dia gnostic criteria but had clinically significant symptoms and functiona l impairment. The most common co-occurrence was depression and anxiety . Comorbidity increases the likelihood of recognition of mental disord ers in general health care, and the likelihood of receiving treatment.