title: Prevalence, detection and management of anxiety and depressive symptoms in unemployed patients attending general practitioners.
abstract: BACKGROUND
  This study examined the detection and management of anxiety and depressive symptoms among unemployed patients attending general practitioners (GPs).
  
  
  METHODS
  A cross-sectional study was undertaken of anxiety and depressive symptoms in general practice using measures completed by patients and GPs. Eligible patients were adults aged 18 to 64 years either working (n = 2273) or unemployed (n = 392).
  
  
  RESULTS
  Eighty per cent of patients were attending their regular GP at the time of the study. Unemployed patients were found to have a higher mean general health questionnaire (GHQ-12) score than employed patients (3.8 compared with 2.4, p < 0.001); were more likely to report symptoms of anxiety and depression which required medical treatment during the previous 4weeks (30.9% compared with 14.6%, p < 0.001); and were more likely to have been treated for anxiety and depression by the GP (27.8% compared with 15.7%, p < 0.001). Among patients who the GPs reported treating for anxiety and depression, unemployed patients were 3.3 times (95% CI: 2.0-5.4) more likely to be prescribed medication than employed patients when severity was controlled but were no more likely to be referred to other health services. Unemployed patients identified increased use of services and were less satisfied with the care that they had received.
  
  
  CONCLUSIONS
  Unemployed patients attending GPs have an increased risk of anxiety and depressive symptoms. Increased prescription of medication as opposed to referral suggests that GPs may treat their unemployed patients differently to employed patients. GPs need to be aware of the higher risk and severity of anxiety and depressive symptoms among unemployed patients and their desire to be more actively involved in their treatment. General practice is an important setting for addressing the health needs of unemployed people.
authors.affiliation: Department of General Practice, Fairfield Hospital, New South Wales, Australia. E.Comino@unsw.edu.au
authors.forename: E J
authors.initials: EJ
authors.lastname: Comino
authors.forename: E
authors.initials: E
authors.lastname: Harris
authors.forename: D
authors.initials: D
authors.lastname: Silove
authors.forename: V
authors.initials: V
authors.lastname: Manicavasagar
authors.forename: M F
authors.initials: MF
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010348:Patient Care Team; D017060:Patient Satisfaction; D012307:Risk Factors; D014478:Unemployment / Q000523:psychology*