title: Use of general practice services 5 years after an episode of mental illness: case-control study using electronic records.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  A case-control study using data from electronic medical records.
  
  
  METHODS
  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 followup 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Practice, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Renée M
authors.initials: RM
authors.lastname: Wildeboer
authors.affiliation: The Netherlands Institute of Health Services Research (NIVEL), Utrecht, the Netherlands.
authors.forename: Lucas
authors.initials: L
authors.lastname: van der Hoek
authors.affiliation: Department of General Practice, University Medical Center Groningen, Groningen; NIVEL, Utrecht, the Netherlands.
authors.forename: Peter Fm
authors.initials: PF
authors.lastname: Verhaak
mesh_terms: D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D057286:Electronic Health Records; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents
keywords: anxiety disorders; depressive disorder; emotional distress; follow-up; general practice; mental health