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The British Journal of Psychiatry (2001) 178: 18-22
© 2001 The Royal College of Psychiatrists

Accuracy of general practitioner's prognosis of the 1-year course of depression and generalised anxiety

ROB H. S. VAN DEN BRINK, PhD, JOHAN ORMEL, PhD, BEA G. TIEMENS, PhD, TITUS W.D.P.VAN OS, MD, ANNET SMIT, MSc and JACK A. JENNER, MD

Department of Psychiatry and Graduate School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands

KLAAS VAN DER MEER, MD

Department of Psychiatry and Department of General Practice, University of Groningen, The Netherlands

Correspondence: Dr R. H. S. Van den Brink, Department of Psychiatry, University Hospital Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Tel: +31 50 3612089; fax: +31 50 3619722; e-mail: r.h.s.van.den.brink{at}med.rug.nl

Declaration of interest No conflict of interest. Public funding detailed in Acknowledgements.

Background A prognosis serves important functions for the management of common mental disorders in primary care.

Aims To establish the accuracy of the general practitioner's (GP) prognosis.

Method The agreement between GP prognosis and observed course was determined for 138 cases of ICD-10 depression and 65 of generalised anxiety disorder, identified among consecutive attenders of 18 GPs.

Results Modest agreement between GP prognosis and course was found, both for depression ({kappa}=0.21) and generalised anxiety ({kappa}=0.11). Better agreement ({kappa}=0.45 for depression, and {kappa}=0.33 for generalised anxiety) was observed between the course and predictions from a statistical model based on information potentially available to the GP at the time the prognosis was made. This model assesses attainable performance for GPs.

Conclusions General practitioners do a fair job in predicting the 1-year course of depression and generalised anxiety. Even so, their performance falls significantly short of attainable performance.




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