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The twelve-month outcome of patients with neurotic illness in general practice

Published online by Cambridge University Press:  09 July 2009

A. H. Mann ,
R. Jenkins  and
E. Belsey
A. H. Mann*
Affiliation:
Institute of Psychiatry, London
R. Jenkins
Affiliation:
Institute of Psychiatry, London
E. Belsey
Affiliation:
Institute of Psychiatry, London
*
1Address for correspondence: Dr A. H. Mann, Academic Department of Psychiatry, Royal Free Hospital, Pond Street, London NW3 2QG.
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Synopsis

One hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year.

The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness charactorized by a rapid recovery after the initial assessemtn. Patients who reported continuous psychiatric morbidity during the year were, older, physically ill and very likely to have recevied psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression.

The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatirc disorders, with symptoms, personality and social state being rated independently.

Type
Research Article
Information
Psychological Medicine , Volume 11 , Issue 3 , August 1981 , pp. 535 - 550
Copyright
Copyright © Cambridge University Press 1981

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References

Andrews, G., Tennant, C., Hewson, D. & Vaillant, G. E. (1978). Life event stress, social support, coping study and risk of psychological impairment. Journal of Nervous and Mental Disease 166, (5), 307–316.CrossRefGoogle Scholar
Bash, E. W. & Bash-Liechti, J. (1974). Studies on the epidemiology of neuro-psychiatric disorders among the population of Shiraz, Iran. Social Psychiatry 9, 163–171.CrossRefGoogle Scholar
Bleuler, M. (1968). A 23 year longitudinal study of 208 schizophrenics and impressions in regard to the nature of schizophrenia. In The Transmission of Schizophrenia (ed. Rosenthal, D. and Kety, S. S.), pp. 3–12. Pergamon Press: Oxford.Google Scholar
Brown, G. W. & Harris, T. (1978). Social Origins of Depression. A Study of Psychiatric Disorder in Women. Tavistock: London.Google Scholar
Brown, G. W., Bhrolchaín, M. N. & Harris, T. (1975). Social class and psychiatric disturbance among women in an urban population. Sociology 9, 225–254.CrossRefGoogle Scholar
Bullock, R. C., Siegel, R., Weissman, M. & Paykel, E. S. (1972). The weeping wife: marital relations of depressed women. Journal of Marriage and the Family 34, 488–495.CrossRefGoogle Scholar
Cassel, J. (1974). An epidemiological perspective of psychosocial factors in disease aetiology. American Journal of Public Health 64, 1040–1043.CrossRefGoogle Scholar
Chan, K. B. (1977). Individual differences in reactions to stress and their personality and situational determinants: some implications for community health. Social Science and Medicine 11, 89–103.CrossRefGoogle Scholar
Clare, A. W. & Cairns, V. E. (1978). Design, development and use of a standardized interview to assess social maladjustment and dysfunction in community studies. Psychological Medicine 8, 589–605.CrossRefGoogle ScholarPubMed
Cobb, S. (1976). Social support as amoderator of life stress. Psychosomatic Medicine 38, 300–314.CrossRefGoogle ScholarPubMed
Cooper, B. (1972). Clinical and social aspects of chronic neurosis. Proceedings of the Royal Society of Medicine 65, 509–512.CrossRefGoogle ScholarPubMed
Cooper, B., Fry, J. & Kalt, G. W. (1969). A longitudinal study of psychiatric morbidity in a general practice population. British Journal of Preventive and Social Medicine 23, 210–217.Google Scholar
Dohrenwend, B. S. & Dohrenwend, B. P. (1974). Stressful Life Events: Their Nature and Effect. John Wiley: New York.Google Scholar
Eastwood, M. R. (1970). Psychiatric morbidity and physical state in a general practice population. In Psychiatric Epidemiology (ed. Hare, E. H. and Wing, J. K.). Oxford University Press: London.Google Scholar
Eastwood, M. R. & Trevalyan, M. H. (1972). Relationship between physical state and psychiatric disorder. Psychological Medicine 2, 363–372.CrossRefGoogle Scholar
Essen-Möller, E. (1971). Suggestion for further improvement of the International Classification of Diseases. Psychological Medicine 1, 308–311.CrossRefGoogle Scholar
Fry, J. (1960). What happensto our neurotic patients? The Practitioner 185, 85–89.Google ScholarPubMed
Goldberg, D. P. (1972). Detecting Psychiatric Illness by Questionnaire. Maudsley Monograph no. 21. Oxford University Press: London.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970). Psychiatric illness in general practice. A detailed study using a new method of case identification. British Medical Journal ii, 439–443.CrossRefGoogle Scholar
Goldberg, D. P. & Cooper, B., Eastwood, M., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in community surveys. British Journal of Preventivee and Social Medicine 24, 18–23.Google ScholarPubMed
Gore, S. (1978). The effect of social support in moderating the health consequences of unemployment. Journal of Health and Social Behaviour 19, 157–165.CrossRefGoogle ScholarPubMed
Greer, S. & Cawley, R. H. (1966). Some Observations on the Natural History of Neurotic Illness. Archdall Medical Monograph no. 3. Australia Publishing Company: Sydney.Google Scholar
Helmchen, H. (1980). Multiaxiaal system of classification. Acta psychiatrica scandinavica 61, 43–55.CrossRefGoogle ScholarPubMed
Henderson, A. S. (1977). The social network, support and neurosis. The function fo attachment in adult life. British Journal of Psychiatry 131, 185–191.CrossRefGoogle ScholarPubMed
Her Majesty's Stationery Office (1970). Socio-Economic Groupings: Classification of Occupations. OPCS HMSO: London.Google Scholar
Her Majesty's Stationery Office (1974). Morbidity Statistics for General Practice – Second National Study 1970–1971. Studies on Medical Population Subjects No. 26. HMSO: London.Google Scholar
Holmes, T. H. & Rahe, R. H. (1967). The Social Readjustment Rating Sclae. Journal of Psychosomatic Research 11, 213–218.CrossRefGoogle Scholar
Huxley, P. J., Goldberg, D. P., Maguire, G. P. & Kincey, V. A. (1979). Prediction of the course of minor psychiatric disorders. British Journal of Psychiatry 135, 535–543.CrossRefGoogle ScholarPubMed
Jenkins, R., Mann, A. H. & Belsey, E. (1981). Design and use of a short interview to assess social stress and support in research and clinical settings. Social Science and Medicine (in the press).CrossRefGoogle Scholar
Johnstone, A. & Goldberg, D. P. (1976). Psychiatric screening in general practice. Lancet i, 605–608.CrossRefGoogle Scholar
Katschnig, H. & Shepherd, M. (1976). Neurosis, the epidemiological perspective.. In Research in Neurosis (ed. van Praag, H. M.), pp. 5–21. Bohn, Schelema and Holdena: Utrecht.Google Scholar
Kedward, H. B. (1969). The outcome of neurotic disorders in the community. Social Psychiatry 4, 1–4.CrossRefGoogle Scholar
Kedward, H. B. & Cooper, B. (1966). Neurotic disorders in an urban practice – a three year follow-up. Journal of the Royal College of General Practitioners 12, 148–162.Google Scholar
Kessel, N. & Shepherd, M. (1962). Neurosis in hospital and general practice. Journal of Mental Science 108, 159–166.CrossRefGoogle ScholarPubMed
Liem, R. & Liem, J. (1978). Social class and mental illness reconsidered: the role of economic stress and social support. Journal of Health and Social Behaviour 19, 139–156.CrossRefGoogle ScholarPubMed
Lin, N., Ensel, W. M., Simeone, R. S. & Kuo, W. (1979). Social support. Sressful life events and illness: a model and an empirical test. Journal of Health and Social Behaviour 20, 108–119.CrossRefGoogle Scholar
Locke, B. Z., Froucome, D. L. & Hasslet, F. (1967). Psychiatric Epidemiology and Mendal Health Planning. Psychiatric Research Report no. 22. APA: Washington, D.C.Google Scholar
Mann, A. H., Jenkins, R., Cutting, J. C. & Cowen, P. J.(1981). The development and use of a standardized assessment of abnormal personality. Psychological Medicine 11 (in the press).CrossRefGoogle ScholarPubMed
Mechanic, D. (1978). Sex, illness, illness behaviour and the use of health services. Social Science and Medicine 12B, 207–214.Google Scholar
Medalie, J. M. & Goldbourt, U. (1976). Angina pectoris among 10000 men: II. Psychosocial and other risk factors as evidenced by a multitude analysis of a five year incidence study. American Journal of Medicine 60, 910–921.CrossRefGoogle Scholar
Murphy, H. B. M. (1976). Which neuroses need specialist care? Canadian Medical Association Journal 115, 540–543.Google ScholarPubMed
Murphy, H. B. M. & Brown, G. W. (1980). Life events, psychiatric disturbance and physical illness. British Journal of Psychiatry 136, 326–338.CrossRefGoogle ScholarPubMed
Ottosson, J. O. & Perris, C. (1973). Multidimensional classification of mental disorders. Psychological Medicine 3, 238–243.CrossRefGoogle ScholarPubMed
Parrish, P. A. (1971). The prescribing of psychotropic durgs in general practice. Journal of the Royal College of General Practitioners 21, suppl. 4.Google Scholar
Paykel, E. S., Emms, E. M., Fletcher, J. & Rasaby, E. S. (1980). Life events and social support in puerperal depression. British Journal of Psychiatry 136, 339–346.CrossRefGoogle ScholarPubMed
Pinneau, S. R. Jr. (1976). Effects of social support on occupational stress and strains.Presented at 84th Annual Convention of American Psychological Association,September.Google Scholar
Querido, A. (1959). Forecast and follow-up. An investigation into the clinical, social and mental factors determining the results of hospital treatment. British Journal of Preventive and Social Medicine 13, 33–49.Google ScholarPubMed
Raynes, N. V. (1979). Factors affecting the prescribing of psychotropic drugs in general practice consultations. Psychological Medicine 9, 671–674.CrossRefGoogle ScholarPubMed
Rutter, M., Shaffer, D. & Shepherd, M. (1973). An evaluation of the proposal for a multiaxial classification of child psychiatric disorders. Psychological Medicine 3, 244–250.CrossRefGoogle ScholarPubMed
Shepherd, M., Cooper, B., Brown, A. & Kalton, G. W. (1966). Psychiatric Illness in General Practice. Oxford University Press: London.Google Scholar
Sims, A. (1975). Factors predictive of outcome in neurosis. British Journal of Psychiatry 127, 54–62.CrossRefGoogle ScholarPubMed
Sims, A. & Prior, P. (1978). The pattern of mortality in severe neuroses. British Journal of Psychiatry 133, 299–305.CrossRefGoogle ScholarPubMed
Skegg, D. G., Doll, R. & Perry, J. (1977). Use of medicines in general pracitice. British Medical Journal i, 1561–1563.CrossRefGoogle Scholar
Stoller, A. & Krupinski, J. (1969). Psychiatric disturbances. In Report on a National Morbidity Survey, ch. 6. NHMRC: Canberra.Google Scholar
Strotzka, H. (1969). Kleinburg: eine social psychiatrie Feldstudie. Austrian State Publishers: Vienna.Google Scholar
Sylph, J., Kedward, H. B. & Eastwood, M. R. (1969). Chronic neurotic patients in a general practice – a pilot study. Journal of the Royal College of General Practitioners 17, 162–170.Google Scholar
Trethowan, W. H. (1975). Pills for personal problems. British Medical Journal iii, 749–751.CrossRefGoogle Scholar
Vaughn, C. E. & Leff, J. P. (1976). The influence of family and social factors on the course of psychiatric illness. A comparison of schizophrenic and depressed neurotic patients. British Journal of Psychiatry 129, 125–127.CrossRefGoogle ScholarPubMed
Williams, P., Tarnopolsky, A. & Hand, D. (1980). Case definition and case identification in psychiatric epidemiology: review and assessment. Psychological Medicine 10, 101–114.CrossRefGoogle Scholar
Wittenborn, R., McDonald, D. C. & Maurer, H. S. (1977). Persisting symptoms in schizophrenia predicted by background factors Archives of General Psychiatry 34, 1057–1061.CrossRefGoogle ScholarPubMed
World Health Organization (1965). Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Disease. WHO: Geneva.Google Scholar