Depression screening in primary care patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S543-S544
Author(s):  
J. Ben Thabet ◽  
M. Turki ◽  
M. Mezghanni ◽  
M. Maalej Bouali ◽  
N. Charfi ◽  
...  
Keyword(s):  
Primary Care ◽  
Suicide Attempt ◽  
Educational Level ◽  
Functional Disability ◽  
Common Mental Disorder ◽  
School Level ◽  
Tunisian Population ◽  
Medical Patients ◽  
Economic Level ◽  
Prevalence Of Depression

IntroductionDepression is a common mental disorder that can be associated with more functional disability than most chronic medical illnesses and the increased reporting of medically unexplained somatic symptoms.AimTo assess the prevalence of depression in a Tunisian population, as well as the associated factors.MethodsWe conducted a cross-sectional, descriptive and analytic study, among 707 subjects consulting in 20 primary care units in Sfax and Tunis, Tunisia. These participants, randomly chosen, were asked to answer a questionnaire after their consent. Depressive symptoms were evaluated using the “Beck Depression Inventory” (BDI).ResultsThe mean age of participants was 39.84 years. Among them, 38.6% had a low educational level (illiterate or primary school level); 45.3% were professionally inactive and 92.9% had a low to medium socio economic level. Medical, psychiatric and suicide attempt histories were reported respectively in 51.2%, 7.6% and 1.8% of cases. According to BDI, a mild depression was noted in 22.9%; moderate 16.1%; severe 4.1%. Among those presenting a moderate to severe depression (MSD), only 16.8% were followed up in psychiatry, 4.2% were receiving antidepressant and 9.8% benzodiazepine. MSD was associated with low educational level (P < 0.001); low to medium socio economic level (P < 0.001); psychiatric histories (P < 0.001); suicide attempt histories (P < 0.001); somatic histories (P < 0.001).ConclusionOur study highlighted a high prevalence of depression that is still under diagnosed and therefore poorly managed. General practitioners should be made aware of the importance of screening for depression in medical patients because it not only complicates their overall medical treatments, but also impedes their physical and social functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Prevalence of depression and past suicide attempt in primary care

2017 ◽  
Vol 27 ◽  
pp. 48-52 ◽  
Author(s):  
Pillaveetil Sathyadas Indu ◽  
Thekkethayyil Viswanathan Anilkumar ◽  
Ramdas Pisharody ◽  
Paul Swamidhas Sudhakar Russell ◽  
Damodaran Raju ◽  
...  
Keyword(s):  
Primary Care ◽  
Suicide Attempt ◽  
Prevalence Of Depression

scholarly journals Implementation of a care manager organisation and its association with antidepressant medication patterns: a register-based study of primary care centres in Sweden

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044959
Author(s):  
Christine Sandheimer ◽  
Cecilia Björkelund ◽  
Gunnel Hensing ◽  
Kirsten Mehlig ◽  
Tove Hedenrud
Keyword(s):  
Primary Care ◽  
Treatment Guidelines ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Antidepressant Medication ◽  
Linear Mixed Effects ◽  
Care Manager ◽  
Defined Daily Doses ◽  
Number Of Patients ◽  
Mental Disorder Diagnosis

ObjectiveTo evaluate the implementation of a care manager organisation for common mental disorders and its association with antidepressant medication patterns on primary care centre (PCC) level, compared with PCCs without this organisation. Moreover, to determine whether a care manager organisation is associated with antidepressant medication patterns that is more in accordance with treatment guidelines.DesignRegister-based study on PCC level.SettingPrimary care in Region Västra Götaland, Sweden.ParticipantsAll PCCs in the region. PCCs were analysed in three subgroups: PCCs with a care manager organisation during 2015 and 2016 (n=68), PCCs without the organisation (n=92) and PCCs that shifted to a care manager organisation during 2016 (n=42).Outcome measuresProportion of inadequate medication users, defined as number of patients >18 years with a common mental disorder diagnosis receiving care at a PCC in the region during the study period and dispensed 1–179 defined daily doses (DDD) of antidepressants of total patients with at least 1 DDD. The outcome was analysed through generalised linear regression and a linear mixed-effects model.ResultsOverall, all PCCs had about 30%–34% of inadequate medication users. PCCs with a care manager organisation had significantly lower proportion of inadequate medication users in 2016 compared with PCCs without (−6.4%, p=0.02). These differences were explained by higher proportions in privately run PCCs. PCCs that shifted to a care manager organisation had a significant decrease in inadequate medication users over time (p=0.01).ConclusionsPublic PCCs had a more consistent antidepressant medication pattern compared with private PCCs that gained more by introducing a care manager organisation. It was possible to document a significant decrease in inadequate medication users, notwithstanding that PCCs in the region followed the guidelines to a comparatively high extent regardless of present care manager organisation.

Social Support, Depression, and Functional Disability in Older Adult Primary-Care Patients

2004 ◽  
Vol 12 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Linda A. Travis ◽  
Jeffrey M. Lyness ◽  
Cleveland G. Shields ◽  
Deborah A. King ◽  
Christopher Cox
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Older Adult ◽  
Functional Disability ◽  
Primary Care Patients

Abstract 18144: Mobile Phone Text Messaging Improves Antihypertensive Drug Adherence in the Community

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Paola Varleta ◽  
Carlos Akel ◽  
Monica Acevedo ◽  
Claudia Salinas ◽  
Javier Pino ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Primary Care ◽  
Mobile Phone ◽  
Antihypertensive Drug ◽  
Educational Level ◽  
Text Messaging ◽  
Health Concern ◽  
Drug Adherence ◽  
Hypertensive Patients

Introduction: Hypertension is a major public health concern and the leading cause of cardiovascular disease worldwide. Prevalence of adequate blood pressure control is low and it is mainly associated to poor antihypertensive drug adherence. We hypothesized that education through mobile phone text messaging (SMS) would improve antihypertensive drug adherence in hypertensive patients followed in a primary care setting. Methods: Recently diagnosed hypertensive patients receiving antihypertensive drug treatment for less than 6 months were randomised to receive SMS related to improve drug adherence and to follow a healthy life style or no messages. Exclusion criteria were history of stroke, heart failure, myocardial infarction and hemodialysis. Patients were recruited from 12 different primary care clinics in Santiago, Chile, where free antihypertensive drug therapy was provided. All patients signed an informed consent after which a survey was performed. Compliance was assessed using Morinsky- Green-Levine Questionnaire.Text messages were sent every 12± 2 days. After a 6-month follow-up, a new survey was applied. An Ordinary Least Squares regression model was used to analyse the net difference between the two groups. Results: A total of 314 subjects were recruited, mean age 60 ±10 years, 35% male, 67% with low or medium educational level (≤12 years). Mean drug pill number was 2.1 per day and the mean time of drug prescription was 4±1 months; 150 subjects were randomised to text messages. No statistical difference between the control and the intervention groups in regards to gender, age, educational level, blood pressure and baseline compliance was found. Eleven patients were lost of follow-up. Adherence in the control group decreased from to 59,7 % at baseline to 51,7% ( p<0,05) at 6 months. By contrast, in the intervention group, it increased from 50,9 % to 62,7 % ( p<0,05). The absolute difference in mean adherence rate between the two groups was 19,8 % (Standard error: 0.081, p: 0.015). Conclusion: This study shows that education through SMS in patients with recently prescribed antihypertensive drugs improved adherence to treatment. SMS could become a good and easy- to- use intervention tool to overcome low adherence to drug treatments in the community.

Understandings of depression among community members and primary healthcare attendees in rural Ethiopia: A qualitative study

2021 ◽  
pp. 136346152110643
Author(s):  
Bethlehem Tekola ◽  
Rosie Mayston ◽  
Tigist Eshetu ◽  
Rahel Birhane ◽  
Barkot Milkias ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Disorders ◽  
Medical Intervention ◽  
Community Members ◽  
Group Discussions ◽  
Individual Interviews ◽  
Rural Ethiopia ◽  
Primary Care Settings ◽  
Prevalence Of Depression ◽  
Community Data

Available evidence in Africa suggests that the prevalence of depression in primary care settings is high but it often goes unrecognized. In this study, we explored how depression is conceptualized and communicated among community members and primary care attendees diagnosed with depression in rural Ethiopia with the view to informing the development of interventions to improve detection. We conducted individual interviews with purposively selected primary care attendees with depression (n = 28; 16 females and 12 males) and focus group discussions (FGDs) with males, females, and priests (n = 21) selected based on their knowledge of their community. Data were analyzed using thematic analysis. None of the community members identified depression as a mental illness. They considered depressive symptoms presented in a vignette as part of a normal reaction to the stresses of life. They considered medical intervention only when the woman's condition in the vignette deteriorated and “affected her mind.” In contrast, participants with depression talked about their condition as illness. Symptoms spontaneously reported by these participants only partially matched symptoms listed in the current diagnostic criteria for depressive disorders. In all participants’ accounts, spiritual explanations and traditional healing were prominent. The severity of symptoms mediates the decision to seek medical help. Improved detection may require an understanding of local conceptualizations in order to negotiate an intervention that is acceptable to affected people.

Common mental disorders in cities

2019 ◽  
pp. 226-238
Author(s):  
Santosh K. Chaturvedi ◽  
Narayana Manjunatha
Keyword(s):  
Economic Growth ◽  
Primary Care ◽  
General Population ◽  
Urban Population ◽  
Somatoform Disorders ◽  
Common Mental Disorders ◽  
Common Mental Disorder ◽  
Healthcare Facilities ◽  
The World ◽  
Global Data

Common mental disorder (CMDs) are the most common psychiatric disorders in the general population, as well as at primary care. They include a triad of three illnesses—depression, anxiety disorders, and somatoform disorders. Global data suggest that the urban population exceeded the rural population in 2007. Cities provide an opportunity for economic growth and comparatively better healthcare facilities. However, what is worrisome is the increased vulnerability for many illnesses, especially CMDs. This chapter reviews the noteworthy literature about CMDs in cities across the world and discusses some of best practices in treating CMDs in various cities.

Depression in Medical Patients

2017 ◽  
pp. 146-159
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care Providers ◽  
Health Personnel ◽  
Time Constraints ◽  
Depression Treatment ◽  
Evidence Based ◽  
Medical Patients ◽  
Care Providers ◽  
Different Levels

Depression treatment that is coordinated with care for comorbid chronic conditions improves control of both the depression and the chronic medical disease. Interpersonal counseling (IPC) and briefer forms of IPT for depression have been introduced in medical practice and primary care to accommodate providers’ time constraints and different levels of training of mental health care providers. IPC is best used with patients who have low levels of depressive symptoms, or distress, and where more highly trained therapists are not available but health personnel are interested in providing counseling. There is high interest in developing briefer approaches for depression treatment in medical patients, a wealth of evidence-based choices, and much work to be done. A case example is given of a college student with comorbid depression and diabetes.

scholarly journals Trajectories of sickness absence, disability pension and unemployment in young immigrants with common mental disorders

2019 ◽  
Vol 29 (6) ◽  
pp. 1055-1062 ◽  
Author(s):  
D Di Thiene ◽  
E Mittendorfer-Rutz ◽  
S Rahman ◽  
M Wang ◽  
K Alexanderson ◽  
...  
Keyword(s):  
Sickness Absence ◽  
Educational Level ◽  
Disability Pension ◽  
Psychiatric Comorbidity ◽  
Common Mental Disorders ◽  
Multinomial Logistic Regression ◽  
Common Mental Disorder ◽  
Duration Of Residence ◽  
Before And After ◽  
Young Immigrants

Abstract Background The aims were to elucidate if trajectories of labour market marginalization (LMM), measured as sickness absence (SA)/disability pension (DP) or unemployment, differed between young immigrants and natives before and after an incident diagnosis of a common mental disorder (CMD), and to investigate if educational level, psychiatric comorbidity and duration of residence in Sweden (in immigrants) had different associations with subsequent LMM in natives compared with immigrants. Methods A total of 28 971 young adults (19–30 years), with an incident CMD (inpatient or specialized outpatient healthcare due to CMDs or dispensed prescribed antidepressants during 2007) were included. Group-based trajectory models were utilized to identify trajectories of annual months of LMM 3 years before and 6 years after the diagnosis. The associations of risk factors with different trajectories were investigated by multinomial logistic regression, χ2-test and Nagelkerke R2 to measure the associations’ strength. Immigrants were categorized into Western and non-Western immigrants. Results Young natives and immigrants showed similar trajectories of SA/DP. A higher proportion of non-Western immigrants (20.5%) followed trajectories of high levels of unemployment (&gt;2 annual months) compared with Western immigrants (15%) and natives (16.5%). Educational level and duration of residence in Sweden (in immigrants) discriminated trajectories of both SA/DP and unemployment, whereas psychiatric comorbidity only discriminated trajectories of SA/DP. Conclusions Differences in trajectories of unemployment between young natives and immigrants with an incident CMD were found. Educational level and psychiatric comorbidity provided information on differences between natives and immigrants and duration of residence gave information for subgroups of immigrants.

Primary Care Patients' Reactions to Mental Health Screening

1996 ◽  
Vol 26 (4) ◽  
pp. 431-441 ◽  
Author(s):  
Mark Zimmerman ◽  
David T. Lush ◽  
Neil J. Farber ◽  
Jon Hartung ◽  
Gary Plescia ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychiatric Treatment ◽  
Primary Care Clinic ◽  
Empirical Support ◽  
Medical Patients ◽  
Care Clinic ◽  
History Of ◽  
Primary Care Patients ◽  
High Level

Objective: The authors examined whether there is empirical support for the notion that medical patients are upset by being asked questions about psychiatric disorders. Method: Six hundred and one patients attending a primary care clinic completed the SCREENER—a newly developed, brief self-administered questionnaire that surveys a broad range of psychopathology. In addition, they completed a second questionnaire that assessed their attitudes toward the SCREENER. Results: We found a high level of acceptance by patients. The questions were judged easy to answer, and they rarely aroused significant negative affect. Fewer than 2 percent of the patients judged the questions difficult to answer, and fewer than 3 percent were “very much” embarrassed, upset, annoyed, or uncomfortable with the questions. Individuals with a history of psychiatric treatment and poorer current mental health reacted more unfavorably to the questionnaire. Conclusions: From the patient's perspective, it is feasible and acceptable to use self-administered questionnaires for routine screening of psychiatric problems in primary care settings.

Sign in / Sign up

Export Citation Format

Share Document