THE RELEVANCE OF RECURRENT BRIEF DEPRESSION IN PRIMARY-CARE - A REPORT FROM THE WHO PROJECT ON PSYCHOLOGICAL-PROBLEMS IN GENERAL HEALTH-CARE CONDUCTED IN 14 COUNTRIES
E. Weiller et al., THE RELEVANCE OF RECURRENT BRIEF DEPRESSION IN PRIMARY-CARE - A REPORT FROM THE WHO PROJECT ON PSYCHOLOGICAL-PROBLEMS IN GENERAL HEALTH-CARE CONDUCTED IN 14 COUNTRIES, European archives of psychiatry and clinical neuroscience, 244(4), 1994, pp. 182-189
This report from the WHO project on Psychological Problems in General
Health Care examines the relevance in primary care of the concept of r
ecurrent brief depression (RBD) proposed by Jules Angst. RBD refers to
brief, severe depressive episodes that recur frequently, i.e. nearly
once a month over a 1-year period, according to Angst. Using a structu
red interview (CIDI), RBD was assessed in patients not meeting the cri
teria for depressive episodes lasting at least 2 weeks, as defined in
the ICD-10 (DE). A substantial proportion of primary care seekers were
identified as presenting RBD without other depressive disorders, 3.7%
with a formal RBD diagnosis and 2.7% with frequent but not monthly de
pressive episodes. These two subgroups were found to differ very littl
e in terms of sociodemographic characteristics, severity, disability,
and comorbidity with other diagnoses. However, in patients with a form
al diagnosis of RBD, a higher rate of history of suicide attempts was
found (14.0%), similar to that observed in patients meeting the criter
ia for DE. Most of the severity and disability indicators show that RB
D is a severe condition, associated with substantial impairment, even
if they show a higher degree of severity for DE. About one RBD patient
out of three is recognized by general practitioners as presenting a p
sychological disorder, a majority of whom are actually treated. Our re
sults confirm the relevance of the concept of RBD in primary care, and
the need to further explore the pertinence of the restrictive recurre
nce criterion proposed by Angst.