Diagnosis and treatment of depression following routine screening in patients with coronary heart disease or diabetes

a database cohort study

C Burton, C Simpson, N Anderson

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND: Depression is common in chronic illness and screening for depression has been widely recommended. There have been no large studies of screening for depression in routine care for patients with chronic illness. Method We performed a retrospective cohort study to examine the timing of new depression diagnosis or treatment in relation to annual screening for depression in patients with coronary heart disease (CHD) or diabetes. We examined a database derived from 1.3 million patients registered with general practices in Scotland for the year commencing 1 April 2007. Eligible patients had either CHD or diabetes, were screened for depression during the year and either received a new diagnosis of depression or commenced a new course of antidepressant (excluding those commonly used to treat diabetic neuropathy). Analysis was by the self-controlled case-series method with the outcome measure being the relative incidence (RI) in the period 1-28 days after screening compared to other times. RESULTS: A total of 67358 patients were screened for depression and 2269 received a new diagnosis or commenced treatment. For the period after screening, the RI was 3.03 [95% confidence interval (CI) 2.44-3.78] for diagnosis and 1.78 (95% CI 1.54-2.05) for treatment. The number needed to screen was 976 (95% CI 886-1104) for a new diagnosis and 687 (95% CI 586-853) for new antidepressant treatment. CONCLUSIONS: Systematic screening for depression in patients with chronic disease in primary care results in a significant but small increase in new diagnosis and treatment in the following 4 weeks.
Original languageEnglish
Pages (from-to)529-537
Number of pages9
JournalPsychological Medicine
Volume43
Issue number3
Early online date18 Jul 2012
DOIs
Publication statusPublished - Mar 2013

Fingerprint

Coronary Disease
Cohort Studies
Databases
Confidence Intervals
Chronic Disease
Antidepressive Agents
Therapeutics
Diabetic Neuropathies
Incidence
Scotland
General Practice
Primary Health Care
Patient Care
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

  • antidepressant treatment
  • coronary heart disease
  • diabetes
  • depression
  • screening

Cite this

Diagnosis and treatment of depression following routine screening in patients with coronary heart disease or diabetes : a database cohort study. / Burton, C; Simpson, C; Anderson, N.

In: Psychological Medicine, Vol. 43, No. 3, 03.2013, p. 529-537.

Research output: Contribution to journalArticle

@article{54d6d0db117e404eaa49791f5b979f17,
title = "Diagnosis and treatment of depression following routine screening in patients with coronary heart disease or diabetes: a database cohort study",
abstract = "BACKGROUND: Depression is common in chronic illness and screening for depression has been widely recommended. There have been no large studies of screening for depression in routine care for patients with chronic illness. Method We performed a retrospective cohort study to examine the timing of new depression diagnosis or treatment in relation to annual screening for depression in patients with coronary heart disease (CHD) or diabetes. We examined a database derived from 1.3 million patients registered with general practices in Scotland for the year commencing 1 April 2007. Eligible patients had either CHD or diabetes, were screened for depression during the year and either received a new diagnosis of depression or commenced a new course of antidepressant (excluding those commonly used to treat diabetic neuropathy). Analysis was by the self-controlled case-series method with the outcome measure being the relative incidence (RI) in the period 1-28 days after screening compared to other times. RESULTS: A total of 67358 patients were screened for depression and 2269 received a new diagnosis or commenced treatment. For the period after screening, the RI was 3.03 [95{\%} confidence interval (CI) 2.44-3.78] for diagnosis and 1.78 (95{\%} CI 1.54-2.05) for treatment. The number needed to screen was 976 (95{\%} CI 886-1104) for a new diagnosis and 687 (95{\%} CI 586-853) for new antidepressant treatment. CONCLUSIONS: Systematic screening for depression in patients with chronic disease in primary care results in a significant but small increase in new diagnosis and treatment in the following 4 weeks.",
keywords = "antidepressant treatment, coronary heart disease, diabetes, depression , screening",
author = "C Burton and C Simpson and N Anderson",
year = "2013",
month = "3",
doi = "10.1017/S0033291712001481",
language = "English",
volume = "43",
pages = "529--537",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "3",

}

TY - JOUR

T1 - Diagnosis and treatment of depression following routine screening in patients with coronary heart disease or diabetes

T2 - a database cohort study

AU - Burton, C

AU - Simpson, C

AU - Anderson, N

PY - 2013/3

Y1 - 2013/3

N2 - BACKGROUND: Depression is common in chronic illness and screening for depression has been widely recommended. There have been no large studies of screening for depression in routine care for patients with chronic illness. Method We performed a retrospective cohort study to examine the timing of new depression diagnosis or treatment in relation to annual screening for depression in patients with coronary heart disease (CHD) or diabetes. We examined a database derived from 1.3 million patients registered with general practices in Scotland for the year commencing 1 April 2007. Eligible patients had either CHD or diabetes, were screened for depression during the year and either received a new diagnosis of depression or commenced a new course of antidepressant (excluding those commonly used to treat diabetic neuropathy). Analysis was by the self-controlled case-series method with the outcome measure being the relative incidence (RI) in the period 1-28 days after screening compared to other times. RESULTS: A total of 67358 patients were screened for depression and 2269 received a new diagnosis or commenced treatment. For the period after screening, the RI was 3.03 [95% confidence interval (CI) 2.44-3.78] for diagnosis and 1.78 (95% CI 1.54-2.05) for treatment. The number needed to screen was 976 (95% CI 886-1104) for a new diagnosis and 687 (95% CI 586-853) for new antidepressant treatment. CONCLUSIONS: Systematic screening for depression in patients with chronic disease in primary care results in a significant but small increase in new diagnosis and treatment in the following 4 weeks.

AB - BACKGROUND: Depression is common in chronic illness and screening for depression has been widely recommended. There have been no large studies of screening for depression in routine care for patients with chronic illness. Method We performed a retrospective cohort study to examine the timing of new depression diagnosis or treatment in relation to annual screening for depression in patients with coronary heart disease (CHD) or diabetes. We examined a database derived from 1.3 million patients registered with general practices in Scotland for the year commencing 1 April 2007. Eligible patients had either CHD or diabetes, were screened for depression during the year and either received a new diagnosis of depression or commenced a new course of antidepressant (excluding those commonly used to treat diabetic neuropathy). Analysis was by the self-controlled case-series method with the outcome measure being the relative incidence (RI) in the period 1-28 days after screening compared to other times. RESULTS: A total of 67358 patients were screened for depression and 2269 received a new diagnosis or commenced treatment. For the period after screening, the RI was 3.03 [95% confidence interval (CI) 2.44-3.78] for diagnosis and 1.78 (95% CI 1.54-2.05) for treatment. The number needed to screen was 976 (95% CI 886-1104) for a new diagnosis and 687 (95% CI 586-853) for new antidepressant treatment. CONCLUSIONS: Systematic screening for depression in patients with chronic disease in primary care results in a significant but small increase in new diagnosis and treatment in the following 4 weeks.

KW - antidepressant treatment

KW - coronary heart disease

KW - diabetes

KW - depression

KW - screening

U2 - 10.1017/S0033291712001481

DO - 10.1017/S0033291712001481

M3 - Article

VL - 43

SP - 529

EP - 537

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 3

ER -