Accuracy of general practitioner's prognosis of the 1-year course of depression and generalised anxiety

Abstract

Background: A prognosis serves important functions for the management of common mental disorders in primary care. Aims: To establish the accuracy of the general practitioner's (GP) prognosis. Method: The agreement between GP prognosis and observed course was determined for 138 cases of ICD-10 depression and 65 of generalised anxiety disorder, identified among consecutive attenders of 18 GPs. Results: Modest agreement between GP prognosis and course was found, both for depression (κ=0.21) and generalised anxiety (κ=0.11). Better agreement (κ=0.45 for depression, and κ=0.33 for generalised anxiety) was observed between the course and predictions from a statistical model based on information potentially available to the GP at the time the prognosis was made. This model assesses attainable performance for GPs. Conclusions: General practitioners do a fair job in predicting the I-year course of depression and generalised anxiety. Even so, their performance falls significantly short of attainable performance. Declaration of interest: No conflict of interest. Public funding detailed in Acknowledgements.