Form, frequency and burden of sleep problems in general health care: a report from the WHO Collaborative Study on Psychological Problems in General Health Care

1996 ◽  
Vol 11 (S1) ◽  
pp. 5s-10s ◽  
Author(s):  
TB Üstün ◽  
M Privett ◽  
Y Lecrubier ◽  
E Weiller ◽  
G Simon ◽  
...  
Keyword(s):  
Health Care ◽  
General Health ◽  
Sleep Problems ◽  
Somatoform Disorders ◽  
General Health Questionnaire ◽  
Collaborative Study ◽  
Alcohol Problems ◽  
Psychological Problems ◽  
Health Questionnaire ◽  
Icd 10

SummaryThe WHO Collaborative Study on Psychological Problems in General Health Care examined the frequency, form, course and outcome of psychological problems in general health care settings. A total of 25,916 general health care attenders at 15 sites in 14 countries were screened using the 12-item General Health Questionnaire (GHQ-12). Of those screened, 5,438 were assessed in detail using a Primary Health Care version of the Composite International Diagnostic Interview (CIDI-PHC) in conjunction with the Brief Disability Questionnaire, the Social Disability Schedules, a self rated overall health status form and the 28-item General Health Questionnaire. The analysis has shown that sleep problems were common at all sites with: 26.8% of all patients having some form of sleep problem and 15% of the patients examined had trouble falling or staying asleep. Of those with sleep problems, 51.5% had a well-defined International Classification of Diseases 10th Revision (ICD-10) mental disorder (such as depression, anxiety, somatoform disorders or alcohol problems) and 48.5% of those with sleep problems for at least two weeks or more did not fulfil the criteria for any well defined ICD-10 diagnosis. Persons with sleep problems reported a degree of disability in the performance of their daily activities and social roles even when they had no symptoms of psychological disorders. When such symptoms were present the disability was significantly increased.

WHO study of psychological problems in general health care. Baseline findings and implications for primary care

1996 ◽  
Vol 5 (3) ◽  
pp. 172-177
Author(s):  
Richard Gater
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Health ◽  
General Health Questionnaire ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Psychological Problems ◽  
Health Questionnaire ◽  
Sono Stati ◽  
Icd 10

RIASSUNTOScopo - Indagare la forma, la frequenza, la gestione e l'esito dei disturbi psichici comuni in pazienti della medicina generale. Disegno - Campionamento a due-stadi di coloro che si rivolgono ai servizi di medicina generale seguito da una valutazione longitudinale a 3 e 12 mesi dello stato mentale, della disabilità e del trattamento, eseguiti utilizzando gli stessi metodi in 15 Centri nel mondo, sotto il coordinamento dell'Organizzazione Mondiale della Sanita. Principali misure utilizzate - General Health Questionnaire, la versione per la medicina generale della Composite International Diagnostic Interview utilizzata per ricavare diagnosi secondo i criteri dell'ICD-10, la Groningen Social Disability Schedule, ed una valutazione da parte del medico di medicina generale dell'attuale stato fisico e mentale insieme ad un riassunto della loro gestione del caso. Risultati - Sono stati sottoposti a screening 25.916 pazienti e sono stati sottoposti a dettagliate interviste 5.438 pazienti. I disturbi psichici tra i pazienti degli ambulatori di medicina generale sono risultati frequenti (in media il 24% di pazienti visti consecutivamente, range 7.3%-52.5%). La disabilità è risultata più elevata nei pazienti con disturbi psichici: quanto più gravi erano i disturbi psichici, tanto pià grave era la disabilità. Il problema principale lamentato dai pazienti era spesso un sintomo somatico, mentre solo una minoranza di essi lamentava un chiaro sintomo psichico. Il riconoscimento dei disturbi da parte dei medici è risultato essere molto diverso tra i diversi Centri e in tutti i Centri metà dei casi ICD-10 non è stata identificata dai medici. I medici operand nell'area di Verona hanno messo in evidenza una particolare distorsione nei riguardi dei disturbi psichici. Un trattamento e stato prescritto a quasi tutti i pazienti che secondo i medici presentavano disturbi psichici, per cui i trattamenti sono risultati simili, indipendentemente dalla diagnosi. Conclusioni - La frequenza dei disturbi psichici nel setting della medicina generale e la disabilità ad essi associata sottolineano la loro importanza per la salute pubblica. Questi sono pazienti che si rivolgono agli ambulatori di medicina generale; la maggior parte di essi continua ad essere trattata in tale setting senza ricorrere ai servizi psichiatrici specialistici. È pertanto importante potenziare il training per il riconoscimento, la diagnosi ed il trattamento dei disturbi psichici comuni sia nelle Facolta di medicina che nei corsi di formazione dei medici di medicina generale.

Depression Comorbid with Anxiety: Results from the WHO Study on Psychological Disorders in Primary Health Care

1996 ◽  
Vol 168 (S30) ◽  
pp. 38-43 ◽  
Author(s):  
Nornam Sartorius ◽  
T. Bedirhan Üstün ◽  
Yves Lecrubier ◽  
Hans-Ulrich Wittchen
Keyword(s):  
Health Care ◽  
General Health ◽  
Health Care Services ◽  
Somatoform Disorders ◽  
Collaborative Study ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Psychological Problems ◽  
World Health ◽  
Health Organization

The World Health Organization collaborative study on “Psychological Problems in General Health Care” investigated the form, frequency, course and outcome of common psychological problems in primary care settings at 15 international sites. The research employed a two-stage case-finding procedure. GHQ–12 was administered to 25 916 adults who consulted health-care services. The second-stage assessment (n=5438) consisted of the Composite International Diagnostic Interview (GDI), the Social Disability Schedule, and questionnaires. Possible cases or borderline cases of mental disorder, and a sample of known cases, were followed up at three months and one year. Using standard diagnostic algorithms (ICD–10), prevalence rates were calculated for current disorder (one-month) and lifetime experience disorder. Well-defined psychological problems are frequent in all the general health-care settings examined (median 24.0%). Among the most common were depression, anxiety, alcohol misuse, somatoform disorders, and neurasthenia. Nine per cent of patients suffered from a “subthreshold condition” that did not meet diagnostic criteria but had clinically significant symptoms and functional impairment. The most common co-occurrence was depression and anxiety. Comorbidity increases the likelihood of recognition of mental disorders in general health care, and the likelihood of receiving treatment.

Recognition and treatment of patients with sleep problems in general health care

1996 ◽  
Vol 11 (S1) ◽  
pp. 11s-14s ◽  
Author(s):  
Y Lecrubier ◽  
E Weiller ◽  
M Privett ◽  
P Boyer ◽  
W Maier ◽  
...  
Keyword(s):  
Health Care ◽  
General Health ◽  
Sleep Problems ◽  
Drug Prescription ◽  
Collaborative Study ◽  
Recognition Rate ◽  
Composite International Diagnostic Interview ◽  
Psychological Problem ◽  
Falling Asleep ◽  
Icd 10

SummaryThe form, frequency and burden of sleep problems in general health care in the WHO Collaborative Study on Psychological Problems are presented in this same issue. This study was conducted in 5,438 primary care patients belonging to 15 centres in 14 countries after 25,916 patients were screened with the GHQ-12. Diagnoses according to the International Classification of Diseases (ICD-10) were obtained from the Composite International Diagnostic Interview (CIDI-PHC). The presence of difficulties falling asleep, staying asleep, waking too early or sleeping too much were assessed by the CIDI. General practitioners (GPs) gave their opinion on the existence of a psychological problem and/or a physical disease and indicated what therapeutic intervention was proposed to patients they recognized as psychological cases. The existence of sleep problems increased the recognition of patients with psychiatric disorders by their GP. No specific subtype of sleep problems influences recognition. The existence of a somatic disease had little influence on the identification of sleep problems as psychological cases. Sleep problems were not frequently expressed as a main presenting complaint. In such a case the recognition rate of patients with ICD-10 diagnosis was unchanged but a sedative treatment was offered more frequently. Overall, 85.9% of patients with sleep problems and recognized as cases were offered treatment, 53.9% drug treatment. The most frequent treatment consumed was stimulants, tonics or vitamins while the most frequently prescribed were antidepressants, hypnotic and anxiolytics with rather similar proportions. Drug consumption was substantially lower than drug prescription.

The factor structure of the General Health Questionnaire (GHQ): a scaled version for general practice in Spain

2006 ◽  
Vol 21 (7) ◽  
pp. 478-486 ◽  
Author(s):  
J.D. Molina ◽  
C. Andrade-Rosa ◽  
S. González-Parra ◽  
H. Blasco-Fontecilla ◽  
M.A. Real ◽  
...  
Keyword(s):  
General Health ◽  
Sleep Disturbances ◽  
Care Setting ◽  
Primary Care Setting ◽  
Sleep Problems ◽  
General Health Questionnaire ◽  
Health Questionnaire ◽  
Predictive Values ◽  
English Population ◽  
Components Analysis

AbstractBackgroundThe 28-item version of the General Health Questionnaire (GHQ-28) developed by Goldberg and Hillier in 1979 is constructed on the basis of a principal components analysis of the GHQ-60. When used on a Spanish population, a translation of the GHQ-28 developed for an English population may lead to worse predictive values.MethodsWe used our Spanish sample to replicate the entire process of construction of the GHQ-28 administered in a primary-care setting.ResultsTwo shorter versions were proposed: one with six scales and 30 items, and the other with four scales and 28 items.ConclusionsThe resulting GHQ-28 was a successful adaptation for use on the Spanish sample. When compared with the original version, only 21 items were the same. Moreover, contrary to the English version, which groups sleep problems and anxiety in the same scale, a scale with items related exclusively to ‘Sleep disturbances’ was found.

Characteristics, recognition and treatment of dysthymics in primary care

1998 ◽  
Vol 13 (4) ◽  
pp. 198-202 ◽  
Author(s):  
Y Lecrubier ◽  
E Weiller
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Health ◽  
General Health Questionnaire ◽  
Composite International Diagnostic Interview ◽  
Psychological Problem ◽  
Diagnostic Interview ◽  
Current Prevalence ◽  
Icd 10 ◽  
Disability Questionnaire

SummaryAs part of the WHO-PPGHC study aimed to better understand the form, frequency and burden of psychiatric conditions in primary care throughout the world, the clinical characteristics of dysthymic patients consulting in primary care were examined. A total of 25,916 general health care attenders at 15 sites in 14 countries were screened using the 12-item General Health Questionaire (GHQ-12). Of those screened, 5,438 were assessed in detail using a Primary Health Care version of the Composite International Diagnostic Interview (CIDI-PHC) in conjunction with among others the Brief Disability Questionnaire (BDQ) and the 28-item General Health Questionnaire (GHQ-28). General practitioners (GPs) gave their opinion on the existence of a psychological problem and indicated what therapeutic intervention was proposed to patients they recognised as psychological cases. The estimated current prevalence of dysthymia as defined by the ICD-10 was 2.1%. The social disability was found to be substantial in patients with dysthymia (52.2% of patients moderately or severely disabled) similar to that observed in patients with Depressive Episode (DE) (57.4%). When both conditions were present, the level of disability was even higher (63.6%). The symptoms presented by dysthymic patients without DE were mostly those specific for the diagnosis of dysthymia (ie, tearful, hopeless, inability to cope, pessimism) while these symptoms were less frequent when dysthymia was complicated by a DE. On the contrary, fatigue and loss of interest were more rarely observed in “pure” dysthymics. In spite of a lower symptomatic severity about half of the patients with dysthymia were recognised as cases by their GPs, a proportion similar to those with DE. However, dysthymics without DE were not, in contrast to patients with DE or with dysthymia and DE, more treated with drugs than non-depressed patients.

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