Chew-Graham Carolyn - ABC of Anxiety and Depression

1. Chapter 09
2. Chapter 10
3. Chapter 11
4. Chapter 12

Anxiety and Depression

EDITED BY

This edition first published 2014, 2014 by John Wiley & Sons, Ltd

BMJ Books is an imprint of BMJ Publishing Group Limited, used under licence by John Wiley & Sons.

Registered Office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK
111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

ABC of anxiety and depression / [edited by] Linda Gask, Carolyn Chew-Graham.
p. ; cm.
Includes bibliographical references and index.

ISBN 978-1-118-78079-4 (pbk.)
I.Gask, Linda, editor.II.Chew-Graham, Carolyn, editor.
[DNLM:1.Depression.2.Anxiety.WM 171.5]
RC537
616.8527dc23

2014020553

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Sarah Alderson
Leeds Institute of Health Sciences, University of Leeds, Leeds, UK

Clare Baguley
Six Degrees Social Enterprise CIC, The Angel Centre, Salford, UK

Richard Byng
Primary Care Group, Institute of Health Services Research, Plymouth University Peninsula School of Medicine and Dentistry, University of Plymouth, Plymouth, UK

Carolyn Chew-Graham
Research Institute, Primary Care and Health Sciences and National School for Primary Care Research, Keele University, Keele, UK

Jody Comiskey
Six Degrees Social Enterprise CIC, The Angel Centre, Salford, UK

Ceri Dornan
Honorary Secretary, UK Balint Society; email:

Chloe Preston
Six Degrees Social Enterprise CIC, The Angel Centre, Salford, UK

Judith Forrest
Derbyshire Healthcare NHS Foundation Trust, UK

Linda Gask
University of Manchester, Manchester, UK

Carol Henshaw
Liverpool Womens NHS Foundation Trust, Crown Street, Liverpool, UK

Allan House
Leeds Institute of Health Sciences, University of Leeds, Leeds, UK

Louise Ivinson
Scottish Association of Psychoanalytical Psychotherapists/British Psychoanalytic Council, 1923 Wedmore Street, London, UK

Cornelius Katona
Department of Psychiatry, University College London, London, UK

David Kessler
School of Social and Community Medicine, University of Bristol, Bristol, UK

R. Hamish McAllister-Williams
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK

James Patterson
Greenmoss Medical Centre, Scholar Green, Stoke on Trent, UK

Jane Roberts
Clinical Innovation and Research Centre, Royal College of General Practitioners, London, UK

Aaron Vallance
Metabolic and Clinical Trials Unit, Department of Mental Health Sciences, The Royal Free Hospital, London, UK

Waquas Waheed
National School for Primary Care Research, University of Manchester, Manchester, UK

Sarah Yates
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK

We hope this book will be a useful resource for anyone who is interested in the management of common mental health problems in the primary care setting. Anxiety and depression are common and often overlap, and patients who suffer from these symptoms are usually managed in primary care.

We have drawn on our clinical experience, working in primary and secondary care, and across the interface. We have used cases of fictitious characters interlinked by living in one street to illustrate the breadth of problems under the umbrella of anxiety and depression, reflecting our professional experiences. We hope that this makes the book appealing to a broad range of readers, including students of health and social care professions, general practitioners and primary care nurses, and practitioners working in specialist care and the voluntary (or third) sector.