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Evaluation of Mood Disorder Patients in a Primary Care Practice: Measures of Affective Temperament, Mental Health Risk Factors, and Functional Health in a Retrospective, Descriptive Study of 35 Patients

Prim Care Companion J Clin Psychiatry 2009;11(2):68-73
10.4088/PCC.07m00575

Objectives: The purpose of this retrospective, descriptive study was to evaluate primary care patients diagnosed with a mood disorder on the basis of the following: (1) comorbid medical illnesses, (2) risk factors for mood disorders and longitudinal presence of symptoms, (3) presence of affective temperament, and (4) functional status and quality of life.

Method: Patients (N = 35) were a convenience sample diagnosed in the Mood Disorder Clinic (MDC), a family practice site-based mental health treatment consultation service. All study patients were assessed using a semistructured interview and diagnosed according to DSM-IV-TR criteria. Data were collected using both chart review and secondary analysis of a computerized touch-screen mood disorders database that included the 36-item Short-Form Medical Outcomes Study Health Survey (SF-36) and an affective temperament survey. The study was conducted from January 2000 through August 2000.

Results: A total of 62 comorbid medical illnesses were present in this group of patients; only 2 patients had no comorbid illnesses. Psychiatric diagnoses included 25 cases (78.1%) of bipolar depression, 5 cases (15.6%) of unipolar or dysthymic depression, and 2 cases (6.3%) of nonmood or anxiety disorders. All patients (100%) had a positive family history for mood disorders or substance abuse. Twenty-four patients (70.6%) had onset of their depressive symptoms prior to age 21, and 11 patients (35.5%) had a positive history of sexual abuse. Affective temperaments were positive in the 30 patients who completed this section. SF-36 scale scores were predominantly below national norms.

Conclusions: The medical comorbidities in our study were expected; the positive family and individual histories for risk along with low SF-36 scores reflect the severity and chronicity of mood disorders in this population.