scholarly journals Cross-sectional analysis of coding, patient characteristics, consultation frequency and pharmacological treatment of adults with severe mental disorders in Irish general practice

Author(s):  
James Larkin ◽  
Ivana Pericin ◽  
Brian Osborne ◽  
Philip Dodd ◽  
Claire Collins

Abstract Background General practitioners are the gatekeepers of Irish healthcare and they offer continuity of care to patients. Irish general practice is therefore considered appropriate for preventing, diagnosing and managing most mental health problems. Aims This study sought to establish the coding frequency, consultation frequency, patient characteristics and pharmacological treatment of patients with severe mental disorders (SMDs) in Irish general practice. Methods A cross-sectional design was used. A finder tool embedded in the practice software assisted general practitioners (GPs) coding adult patients with SMDs. Eleven practices uploaded anonymous data on 2,203 patients. Variables analysed included disease code, consultations, prescriptions, sex, patient status and age. Results Overall, 2.9% (n = 2,337) of patients had ever been coded with a SMD, 2.4% (n = 1,964) coded with depressive disorder ever and 0.26% (n = 209) and 0.3% (n = 233) with bipolar disorder and schizophrenia, respectively. Overall, 68.0% (n = 1,336) of patients with depressive disorder were female, and 74.0% (n = 171) of patients with schizophrenia were public patients. The median consultation rate in the previous 3 years was highest for schizophrenia patients at 24.5 visits. Conclusions Coding of SMDs in Irish general practice appears incomplete. Patients with SMDs have high consultation rates. Patients with depressive disorder are more likely to be female and public patients. This research suggests that the improvement of coding in Irish general practice is the first practical step required to detecting prevalence rates.

Author(s):  
Deviani Saskia Putri ◽  
Ayun Sriatmi ◽  
Eka Yunila Fatmasari

Background: Treatment adherence among patients with severe mental disorders is needed to avoid drop-outs, relapses, and shackling. Kedungmundu Primary Health Center in Semarang City is known to have a low treatment adherence to patients with severe mental disorders. This study aimed to determine the factors associated with treatment adherence among patients with severe mental disorders.Methods: A quantitative study with a cross-sectional approach. The samples were 73 patients with severe mental disorders at The Kedungmundu Primary Health Center. Data were collected using questionnaires and analyzed using frequency distribution analysis and Spearman Rank Correlation Test.Results: The results indicated that knowledge (p = 0,000; r = 0,715), attitudes (p = 0,000; r = 0,839), family support (p = 0,000; r = 0,427), assessment of health workers (p = 0,000; r = 0,456), and the need for health services (p = 0,000; r = 0,716) have a positive correlation with treatment adherence among severe mental disorders patients.Conclusion: Kedungmundu Primary Health Center is suggested to provide psychoeducation to patients and families, improve the implementation of mental health programs, and empower mental health cadres.


2006 ◽  
Vol 37 (1) ◽  
pp. 61-71 ◽  
Author(s):  
SING LEE ◽  
ADLEY TSANG ◽  
MING-YUAN ZHANG ◽  
YUE-QIN HUANG ◽  
YAN-LING HE ◽  
...  

Background. This is the first study to examine variation across cohorts in lifetime risk of DSM-IV mental disorders in metropolitan China.Method. Face-to-face household interviews of 2633 adults in Beijing and 2568 adults in Shanghai were conducted from November 2001 to February 2002 using a multi-stage household probability sampling method. The Chinese World Mental Health (WMH) Survey Initiative version of the WHO Composite International Diagnostic Interview (WMH-CIDI) was used for assessment.Results. Lifetime prevalence of any disorder was 13·2%. Alcohol abuse (4·7%), major depressive disorder (3·5%), and specific phobia (2·6%) were the most common disorders. The median age of onset was later for mood (43 years) than anxiety (17 years) and substance use (25 years) disorders. Compared to observed lifetime prevalence, the projected lifetime risk as of age 75 years increased by 106% for major depressive disorder (7·2%), and was uniformly higher for all disorders. Relative odds of any lifetime disorder were 4·7 in the most recent cohorts (ages 18–34) compared to the eldest cohorts (ages [ges ]65).Conclusions. The findings of this cross-sectional study tally with the view that rapid socioeconomic changes may bring about increasing incidence of mental disorders in China. However, prospective longitudinal studies are needed to confirm if the increase is real. Because of the huge size of the Chinese population, any increase in projected lifetime risk of mental disorders represents an enormous increase in the number of affected individuals.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jessica Hanae Zafra-Tanaka ◽  
Kevin Pacheco-Barrios ◽  
Fiorella Inga-Berrospi ◽  
Alvaro Taype-Rondan

Abstract Aim To assess the self-perceived competencies in diagnosing and treating patients with mental health disorders, among recently graduated general practitioners (GPs) from Lima, Peru. Methods A cross-sectional study was performed in April 2017 at a General Practitioner’s meeting held for those who were going to perform the social service, by the Peruvian College of Physicians in Lima. Attendees were invited to answer a questionnaire that evaluated their self-perception of competence in diagnosing and treating four different mental health disorders; major depression, anxiety disorder, alcohol dependence, and schizophrenia. Results Out of 434 evaluated GPs, the following percentages were self-perceived as competent in their adequate diagnosis of depression (70.5%), anxiety (73.3%), alcohol dependence (67.6%), and schizophrenia (62.0%). Concerning pharmacological treatment, these percentages were 46.6, 47.5, 39.0 and 37.6%, respectively. Referring to all the studied mental disorders, 41.6% of participants self-perceived competence in providing an adequate diagnosis, 36.1% in providing non-pharmacological treatment, and 20.1% in providing pharmacological treatment. Conclusion The rate of adequate self-perceived competences was higher for diagnosis than for treatment of patients with mental health disorders. These results highlight the importance of designing and implementing interventions to improve medical education so as to develop the skills necessary to confront mental health disorders.


2006 ◽  
Vol 23 (1) ◽  
pp. 6-9 ◽  
Author(s):  
Blanaid Gavin ◽  
Walter Cullen ◽  
Brian O'Donoghue ◽  
Juan Carlos Ascencio-Lane ◽  
Gerard Bury ◽  
...  

AbstractObjective: We sought to establish the views of general practitioners about detecting and managing patients with a first episode of schizophrenia in Ireland.Method: Twenty per cent of GPs were invited to participate in a cross-sectional postal survey.Results: Sixty-two per cent (n = 261) participated. Almost all (99.2%) see at least one case of suspected first episode schizophrenia annually. The most commonly (80.7%) encountered symptom is ‘bizarre behaviour’. Many (47.7%) rarely or never prescribe antipsychotics to patients whom they suspect have a first episode of schizophrenia. However, 80.6% of GPs reported that they ‘always’ refer this group of patients to psychiatric services. Over half (57.8%) advised patients with schizophrenia to continue medication for less than a year. A large number of respondents reported that it is difficult to obtain a rapid psychiatric assessment.Conclusions: GPs want more information about identifying early psychosis, a closer liaison with psychiatric services and a rapid intervention service.


2018 ◽  
Vol 5 ◽  
pp. 233339281875852 ◽  
Author(s):  
Michael Linden ◽  
Beate Muschalla ◽  
Nils Noack ◽  
Christoph Heintze ◽  
Susanne Doepfmer

Objective: To determine whether a psychiatric–psychosomatic consultation can identify unmet treatment needs and improve treatment of patients with mental disorders in general practice. Methods: In 40 primary care practices, 307 consecutive primary patients who met criteria for chronic mental disorders were assessed by a psychiatric–psychosomatic consultant. After random assignment, general practitioners (GPs) were informed for half of the patients about the results of the assessment and received recommendations on how to improve treatment. Changes in treatment and patient status were reevaluated after 6 months. Results: Patients were mostly having depression, adjustment, or anxiety disorders, with 28.8% on sick leave. Contact with their respective GPs was longer than a year in 77.2% of cases. Patients had already received pharmacotherapy (60.9%), psychotherapeutic counseling by GPs themselves (27.7%), psychotherapy by specialists (73.9%), psychiatric outpatient care (57%), inpatient psychiatric treatment (12.1%), inpatient psychosomatic rehabilitation (ie, specialized behavioral medicine facilities for patients with work problems; 41.4%), and a broad spectrum of other diagnostic and therapeutic measures. Newly recommended interventions included leisure activities (42%), a new specialist psychotherapy (37.5%), or inpatient psychosomatic treatment (15.3%). Most recommendations were agreed upon by the GP. Nevertheless, there was only a limited increase in therapeutic actions 6 months later, and no statistically significant improvement in the status of patients. Conclusion: General practitioners undertake a broad spectrum of therapeutic interventions in patients with chronic mental disorders. According to our results, additional psychiatric–psychosomatic consultations can intensify treatment but does not significantly change the general course of chronic mental disorders.


2001 ◽  
Vol 81 (3) ◽  
pp. 915-923 ◽  
Author(s):  
Carsten Krogh Jørgensen ◽  
Per Fink ◽  
Frede Olesen

Abstract Background and Purpose. Both musculoskeletal illness and mental illness characterized by somatic symptoms are common in primary care, and it is hypothesized that many patients with musculoskeletal illness have relatively poor mental health. The purpose of this study was to describe the characteristics of patients in general practice in Denmark who are referred to physiotherapists with signs and symptoms of musculoskeletal illness. Subjects and Methods. One hundred ninety-four general practitioners, representing 124 practices, participated in a survey of 2,042 consecutive patients with musculoskeletal illness. Results. The diagnoses were generally poorly defined. Compared with the general population, patients with musculoskeletal illness had markedly poorer physical health and poorer mental health. Patients with poorly defined diagnoses did not differ from patients with well-defined diagnoses in terms of physical health, but they scored lower on the mental health component summary scale of the Danish version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Conclusion and Discussion. Of the patients referred to physiotherapists by general practitioners in Denmark, the subgroup with poorly defined diagnoses had lower mental health scores than those with well-defined diagnoses, suggesting that a biopsychosocial approach to care may be appropriate for this group of patients.


2019 ◽  
Vol 5 (2) ◽  
pp. 128-132
Author(s):  
Dewi Retno Pamungkas ◽  
One May Linawati ◽  
Puji Sutarjo

Background: Stigma is a negative view of individuals that would have influences on how they feel about, and act upon others. Stigma towards people with mental health problems will negatively affect their recovery process. At a stage of their education, nursing students will meet with people with mental disorders. It is important to analyze their view towards people with mental disorders. Objective: This research aimed to gain an overview on nursing students’ stigma towards people with mental disorders at Stikes Jenderal Achmad Yani Yogyakarta. Methods: This study was descriptive quantitative with a cross sectional method and proportionate random sampling technique, involving 81 respondents. Data were obtained through a questionnaire.  Students’ stigma was viewed from several aspects including education, gender, age and ethnicity. Stigma was assessed in three categories; low, moderate and high level of stigma. Result: Result showed that within the categories, the highest prevalence was in the moderate level of stigma (96.3% or 78 people), high level of stigma accounted for 3.7% (3 people), and there was not respondent with low level of stigma. Conclusion: The majority of nursing students at Stikes Jenderal Achmad Yani Yogyakarta had moderate level of stigma. Keywords: Stigma, mental disorder, nursing student


2019 ◽  
Vol 48 (1-2) ◽  
pp. 66-71 ◽  
Author(s):  
Belinda O'Sullivan ◽  
Deborah Russell ◽  
Matthew McGrail ◽  
Marisa Sampson ◽  
Allyson Warrington ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document