Guidelines Management of generalised anxiety disorder in adults: summary of NICE guidance

National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK.
BMJ (online) (Impact Factor: 16.38). 01/2011; 342:c7460. DOI: 10.1136/bmj.c7460
Source: PubMed
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    ABSTRACT: Background: Major depressive disorder (MDD) has shown to cause high costs to society. Earlier research indicates that generalized anxiety disorder (GAD) also causes high costs, but only limited data is available in varying settings. Aims: To analyse the secondary care costs of GAD compared with those of MDD. Methods: Retrospective database analysis from Finnish Hospital Discharge Registers (FHDR). All GAD and MDD patients diagnosed between 1 January 2007 and 31 December 2007 in FHDR were recorded and individual-level secondary care costs during a 48-month follow-up period were measured. Results: The total mean cost of GAD with history of MDD or some other anxiety disorder was significantly higher than that of MDD with history of GAD or some other anxiety disorder during the 48-month follow-up period. The costs of pure GAD were comparable with those of pure MDD, but after adjusting for age and sex, the costs of pure MDD were higher than those of pure GAD. Conclusions: The economic burden of individual GAD patients is comparable with that of MDD patients in secondary care.
    Nordic journal of psychiatry 08/2013; 68(5). DOI:10.3109/08039488.2013.817605 · 1.50 Impact Factor
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    ABSTRACT: I thought that the publication of the review on preventing exacerbations of chronic obstructive pulmonary disease (COPD) (from Drug and Therapeutics Bulletin; DTB) and the summary of National Institute for Health and Clinical Excellence guidance on the management of generalised anxiety disorder in adults …
    BMJ Clinical Research 12/2010; 342. DOI:10.1136/bmj.d995 · 14.09 Impact Factor
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    ABSTRACT: Background: Patients who visit their General Practitioner (GP) very frequently over extended periods of time often have multimorbidity and are costly in primary and specialist healthcare. We investigated the impact of patient-level psychosocial and GP-level factors on the persistence of frequent attendance (FA) in primary care. Methods: Two-year prospective cohort study in 623 incident adult frequent attenders (N90th attendance centile; age and sex-adjusted) in 2009. Information was collected through questionnaires (patients, GPs) and GPs' patient data. We used multilevel, ordinal logistic regression analysis, controlling for somatic illness and demographic fac-tors with FA in 2010 and/or 2011 as the outcome. Results: Other anxiety (odds ratio (OR) 2.00; 95% confidence interval from 1.29 to 3.10) over 3 years and the number of life events in 3 years (OR 1.06; 1.01–1.10 per event; range of 0 to 12) and, at baseline, panic disorder (OR 5.40; 1.67–17.48), other anxiety (OR 2.78; 1.04–7.46), illness behavior (OR 1.13; 1.05–1.20 per point; 28-point scale) and lack of mastery (OR 1.08; 1.01–1.15 per point; 28-point scale) were associated with persistence of FA. We found no evidence of synergistic effects of somatic, psychological and social problems. We found no strong evidence of effects of GP characteristics. Conclusion: Panic disorder, other anxiety, negative life events, illness behavior and lack of mastery are indepen-dently associated with persistence of frequent attendance. Effective intervention at these factors, apart from their intrinsic benefits to these patients, may reduce attendance rates, and healthcare expenditures in primary and specialist care.
    Journal of Psychosomatic Research 08/2014; j.jpsychores.2014.08.003.. DOI:10.1016/j.jpsychores.2014.08.003 · 2.84 Impact Factor


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