background It is likely that ‘real life’ patients differ from patients included in randomised controlled trials (rcts) and from nontreatment seeking patients in the general population. For example patients with suicidality or comorbidity are often excluded from rcts. However, much of what is known about characteristics of patients with depression and anxiety is based on rcts and studies in the general population. Data on ‘naturalistic’ or ‘real life patients’ are scarce.
aim We investigated specific characteristics of patients with depression and anxiety in psychiatric specialty care. The first study explored gender differences in depression (Van Noorden 2010). The second study explored differences in age of onset of depression. The third study aimed to establish predictors for deliberate self-harm and suicidal ideation (dshi) in patients with depression and anxiety.
method We used baseline data of the routine outcome monitoring (rom) study. From 2004-2007, 3798 patients had been routinely assessed with rom. rom was performed by specially trained nurses and consisted of both selfreport and observational instruments.
results No gender differences were found in depressive outpatients on observational instruments that measure severity of depression. However, female patients reported more and more severe complaints on self-report instruments, as well as worse general health. In addition, patients with an onset of depression before the age of 18 years, reported more current suicidality and previous suicide attempts. Finally, low education, being unmarried, comorbidity, having more symptoms of anxiety and depression, and emotional instability were independent predictors of dshi.
conclusion The findings of our studies in naturalistic outpatients differed from previous findings based on rcts and studies in the general population. Since our findings are based on routinely obtained measurements in treatment seeking patients, these data may reflect the phenomenology of real life patients more closely.