Use of general practice services 5 years after an episode of mental illness: case-control study using electronic records

Background Depression, anxiety, and emotional distress occur frequently and are usually treated in general practice. Little has been reported about the long-term course of these conditions and the long-term use of medical services. Aim To follow up patients with depression, anxiety, and emotional distress in general practice for 5 years and examine the length and number of index episodes, prescribing behaviour, and the use of services in general practice. Design and setting A case-control study using data from electronic medical records. Method Three cohorts of patients with depression (n = 453), anxiety (n = 442), and emotional distress (n = 185) were compared against a cohort of control patients (n = 4156) during a 5-year follow-up from 2007 to 2011. The occurrence or recurrence of the index disorders, other psychological disorders or medical conditions, the numbers of prescriptions, and the number of contacts with the general practice were all examined. Results Patients in the depression group had 1.1 follow-up episodes of depression, those in the anxiety group had 0.9 follow-up episodes of anxiety, and those in the emotional distress group had 0.5 follow-up episodes of emotional distress during the 5 years. All three groups had more consultations (for both psychological and somatic reasons) during each of the follow-up years than control patients. Furthermore, the groups with mental health disorders were given more prescriptions for psychopharmacological treatment. Conclusion Five years after the index episode in 2007, patients with an episode of depression, anxiety, or emotional distress are still not comparable with control patients, in terms of the prevalence of mental health conditions, the number of prescriptions, and healthcare use