Abstract

MARSIGLIA G., Italo. Estudio clínico y epidemiológico de la ansiedad y la depresión en una muestra de 1 159 pacientes . Gac Méd Caracas. [online]. 2010, vol.118, n.1, pp.03-10. ISSN 0367-4762.

For the internist, the term “functional disturbance” refers to the patient´s manifestation that has no known pathological substratum. The term “functional patient” distinguishes the affected by a psychological, emotional or psychosomatic disorder. In our clinical experience, many functional manifestations are referred by patients with anxiety or depression. The present study analyzed the epidemiological and clinical characteristics of anxiety and depression in a Venezuelan sample of 1 159 patients seen, consecutively and for the first time, in an internal medicine consult in the Caracas metropolitan area. Depression was found in 88 cases, with a prevalence of 7.6 %. Female: male ratio was 2.1: 1 and age (X±1SD) 54.06±15.15 years, 6.2 years older than in the total population. Depression was very common in the elderly (37.5 % of depression cases vs. 28.3 % of elderly in the sample). Depression was diagnosed in 1/4 of the cases as primary affective disorder, and in the 3/4 remaining, depression as a adaptative disorder to psychological stress  or secondary depression due to other medical diseases. Anxiety was present in 160 cases, having a prevalence of 13.8 %. The female: male ratio was 2.4: 1 and age (X±1SD) 46.77±16.35 years, without significant difference with the mean of the sample and 7.3 years younger than in depression cases. In anxiety, the elderly were 16.15 % of cases, percentage significantly minor than the elderly in the sample (28.30 %). In 36.25 % of the cases, anxiety was due to primary psychiatric disorder, specially panic or primary affective disorders. Generalized anxiety disorder was diagnosed in 63.75 % of cases. 20.45 % of 1 159 patients or, one out of five patients, presented manifestations of anxiety and/or depression (248 cases of anxiety and/or depression in 237 patients). We conclude that: 1) Anxious and depressive disorder are very common in the internist practice; 2) Functional disturbance, specially the related with many systems, affected nearly all patients with anxiety or depression, and its presence must rule out a psychiatric disorder concealed or masked by these physical manifestations; 3) Equally, the internist must be trained to diagnose these psychiatric disorders that are common in primary attention consults, emergency and hospital rooms, and it’s not exceptional to observe a panic patient end his hospital stay in the intensive care unit.