Treatment of mental health problems in general practice: a survey of psychotropics prescribed and other treatments provided

2007 ◽  
Vol 45 (01) ◽  
pp. 23-29 ◽  
Author(s):  
E. van Rijswijk ◽  
M. Borghuis ◽  
E. van de Lisdonk ◽  
F. Zitman ◽  
C. van Weel
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Mental Health Problems ◽  
Health Problems

scholarly journals Applying Computerized Adaptive Testing to the Four-Dimensional Symptom Questionnaire (4DSQ): A Simulation Study

2017 ◽  
Vol 4 (1) ◽  
pp. e7 ◽  
Author(s):  
Tessa Magnée ◽  
Derek P de Beurs ◽  
Berend Terluin ◽  
Peter F Verhaak
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Simulation Study ◽  
Computerized Adaptive Testing ◽  
Mental Health Problems ◽  
Adaptive Testing ◽  
Health Problems ◽  
Measurement Precision ◽  
Stopping Rule ◽  
Symptom Questionnaire

Background Efficient screening questionnaires are useful in general practice. Computerized adaptive testing (CAT) is a method to improve the efficiency of questionnaires, as only the items that are particularly informative for a certain responder are dynamically selected. Objective The objective of this study was to test whether CAT could improve the efficiency of the Four-Dimensional Symptom Questionnaire (4DSQ), a frequently used self-report questionnaire designed to assess common psychosocial problems in general practice. Methods A simulation study was conducted using a sample of Dutch patients visiting a general practitioner (GP) with psychological problems (n=379). Responders completed a paper-and-pencil version of the 50-item 4DSQ and a psychometric evaluation was performed to check if the data agreed with item response theory (IRT) assumptions. Next, a CAT simulation was performed for each of the four 4DSQ scales (distress, depression, anxiety, and somatization), based on the given responses as if they had been collected through CAT. The following two stopping rules were applied for the administration of items: (1) stop if measurement precision is below a predefined level, or (2) stop if more than half of the items of the subscale are administered. Results In general, the items of each of the four scales agreed with IRT assumptions. Application of the first stopping rule reduced the length of the questionnaire by 38% (from 50 to 31 items on average). When the second stopping rule was also applied, the total number of items could be reduced by 56% (from 50 to 22 items on average). Conclusions CAT seems useful for improving the efficiency of the 4DSQ by 56% without losing a considerable amount of measurement precision. The CAT version of the 4DSQ may be useful as part of an online assessment to investigate the severity of mental health problems of patients visiting a GP. This simulation study is the first step needed for the development a CAT version of the 4DSQ. A CAT version of the 4DSQ could be of high value for Dutch GPs since increasing numbers of patients with mental health problems are visiting the general practice. In further research, the results of a real-time CAT should be compared with the results of the administration of the full scale.

scholarly journals Concurrent opioid dependence and mental health problems: a review of the issues for general practice

2001 ◽  
Vol 24 (4) ◽  
pp. 188 ◽  
Author(s):  
Janice Duffy ◽  
Alex Ask ◽  
Colin Macdougall
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Health Professionals ◽  
Opioid Dependence ◽  
Mental Health Problems ◽  
Health Centre ◽  
Health Problems ◽  
Shared Care ◽  
Liaison Psychiatry ◽  
Care Community

The literature is reviewed on the issue of concurrent opioid dependence and mental health problems within the general practice setting. People with such problems have poorer personal, clinical and social outcomes than people with either mental health or drug and alcohol (D&A) problems alone. Mental health and drug services operate from different policy systems and are generally not co-ordinated with each other, leaving the onus on the patient to move effectively through health systems. The common statement that GPs are ideal health professionals to manage concurrent problems is contrasted with the evident barriers in general practice such as lack of time, knowledge, skills and confidence. Models for managing concurrent problems tend towards shared care. However, these models either have received mixed evidence (eg. consultant-liaison psychiatry) or are amenable to development but remain untested (eg. co-ordinated care, community health centre programs). The Enhanced Primary Care items introduced in 1999/2000 may provide an incentive for GPs to participate in shared care arrangements with other health professionals. However, there is a need for mechanisms to increase the links between GPs and other health services.

scholarly journals Mental health problems and the presentation of minor illnesses: Data from a 30-year follow-up in general practice

2008 ◽  
Vol 14 (sup1) ◽  
pp. 38-43 ◽  
Author(s):  
Tim Olde Hartman ◽  
Eric van Rijswijk ◽  
Hiske van Ravesteijn ◽  
Lieke Hassink-Franke ◽  
Hans Bor ◽  
...  
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Mental Health Problems ◽  
Health Problems

scholarly journals Competence of general practice nurses caring for patients with mental health problems in the somatic departments

Medicina ◽  
2009 ◽  
Vol 45 (10) ◽  
pp. 822 ◽  
Author(s):  
Ligija Švedienė ◽  
Lina Jankauskienė ◽  
Marija Kušleikaitė ◽  
Artūras Razbadauskas
Keyword(s):  
Mental Health ◽  
General Practice ◽  
Mental Health Problems ◽  
Response Rate ◽  
Health Problems ◽  
Psychiatric Consultation ◽  
Practice Nurses ◽  
Anonymous Questionnaire ◽  
Conflict Situations ◽  
Secondary Health Care

Objective. To investigate competence of general practice nurses caring for patients with mental health problems in the somatic departments. Material and methods. A quantitive study on competence of general practice nurses using an anonymous questionnaire was carried out in Klaipėda secondary health care institution in January–February of 2007. The respondents (128 general practice nurses) were selected from seven departments, in which psychiatric consultation was more frequently recommended. In the working places of nurses, 140 questionnaires were distributed; 135 questionnaires were completed (response rate was 96.4%), among them 7 questionnaires were acknowledged as not valid. Results. About 45.0% of general practice nurses had knowledge how to care for the patients with mental health problems, from 1.6 to 21.9% did not have knowledge, and the rest reported having only moderate knowledge (28.1–64.1%). These findings provided a statistically significant link between the duration of employment and education (r from 0.292 to 0.76; P from <0.05 to <0.01). However, only 30.5% of respondents were able to manage conflicts. Most common undesirable events (60.3%) were runaway from inpatient clinic care, injury followed by runaway (29.4%), and suicide (10.3%). From 18.8% to 28.9% of respondents believed that undesirable events were influenced by an unsuitable environment of the department, the shortage of time and personnel, difficulty in getting a psychiatrist’s consultation. Only 3.1% of respondents thought that these undesirable events might be affected by the lack of competence of personnel. Most of the nurses (form 75.0% to 84.4%) had a positive attitude toward the patients; however, the nursing principles were recognized only by (6.3% to 24.2%) of respondents. Conclusions. Competence of the nurses caring for the patients with mental health problems is not at the level required. This may be associated with insufficient professional skills, conflict situations with the patients, and the lack of acknowledgment of the principles of nursing.

Child and Adolescent Psychiatry in General Practice

2001 ◽  
Vol 35 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Elena Garralda
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Child And Adolescent ◽  
Health Problems ◽  
Undergraduate Teaching ◽  
Further Development

Objective: This review discusses the role of general practitioners and primary care health staff in the assessment, treatment and prevention of child and adolescent psychiatric disorders and to consider implications for service delivery. Method: Literature review. Papers were selected as having an empirical evidence base or as describing and documenting new initiatives in general practice. Results: A small proportion of about 3% of children present to general practice with behavioural or emotional problems, but psychiatric disorders in the context of somatic presentations are considerably more common. They are probably higher than in the general population reflecting an increased tendency by children with disorders to consult. Recognition by general practitioners is limited and few children with disorders are referred to specialist clinics. However, referrals are mostly appropriate: the more severely affected children in difficult psychosocial circumstances. A number of pilot studies have shown the feasibility and potential usefulness of setting up shifted specialist clinics in primary care and of training primary care doctors and other staff in the recognition or management of child mental heath problems. Conclusion: Primary care is an appropriate resource to help increase attention to child and adolescent mental health problems. Its potential requires further development and rigorous evaluation. Areas lending themselves to development include: improved medical undergraduate teaching and postgraduate training; suitable information and advice-giving on child mental health problems by the primary care team; the development of specific child and adolescent psychiatric interventions for use in the primary care setting; careful and discriminating development of shifted outpatient clinics for selected child psychiatric disorders; the development of focused protocols for referral to specialist services; further development of mental health promotion clinics in primary care.

Mental health in general practice: assessment of current state and future needs

2005 ◽  
Vol 22 (3) ◽  
pp. 83-86 ◽  
Author(s):  
Mimi Copty ◽  
David L Whitford
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Health Services ◽  
Postgraduate Training ◽  
Mental Health Problems ◽  
Health Problems ◽  
Psychiatric Services ◽  
Psychological Therapies

AbstractObjectives: To determine the extent of mental health services provided in the community in one Irish health board area. To examine the influence of postgraduate mental health training of GPs on provision of mental health services.Method: Questionnaire and focus group methods were employed to determine views on mental health service provision. Data analysis was with parametric and non-parametric tests of association including student's t and chi-squared tests. Thematic analysis of the focus groups was carried out.Results: Twenty-five per cent of patients attending general practice have mental health problems and over 95% of these problems are dealt with in primary care. Only 32% of GPs had received postgraduate training in psychological therapies. GPs with postgraduate training in psychological therapies were more likely to estimate a higher proportion of their patient population with mental health problems and less likely to refer to psychiatric services. A need for support from other health care professionals in primary care was also identified.Conclusion: The majority of patients with mental health problems are treated in primary care. Further training of GPs and increased resources would improve mental health care in primary care and lead to fewer referrals to psychiatric services.

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