Post-traumatic stress disorder in primary-care settings: prevalence and physicians' detection

2001 ◽  
Vol 31 (3) ◽  
pp. 555-560 ◽  
Author(s):  
O. TAUBMAN-BEN-ARI ◽  
J. RABINOWITZ ◽  
D. FELDMAN ◽  
R. VATURI
Keyword(s):  
Primary Care ◽  
Psychological Distress ◽  
Primary Care Physicians ◽  
Demographic Data ◽  
National Sample ◽  
Self Report ◽  
National Study ◽  
Post Traumatic Stress ◽  
Primary Care Settings ◽  
General Psychological Distress

Background. Little is known about the prevalence of PTSD in primary-care settings and regarding the ability of primary-care physicians to detect PTSD. The current study examines prevalence of PTSD in a national sample of primary-care attenders and primary-care physicians' detection of PTSD and general psychological distress in PTSD patients.Methods. Data are from a national study of 2975 primary-care attenders in Israel. Demographic data, responses to the GHQ-28, PTSD Inventory and physicians' diagnoses were examined.Results. Twenty-three per cent of all patients who attended clinics (N=684) reported traumatic events, 39% of whom (males 37%, females 40%) met criteria for PTSD on the PTSD Inventory. Eighty per cent of the males and 92% of the females with PTSD were distressed according to the GHQ. According to physicians, 37% of persons who reported trauma (40% of the women, 32% of the men) suffered from psychological distress. Only 2% of patients meeting PTSD criteria on the self-report measure were given a diagnoses of PTSD by physicians.Conclusions. Many primary-care patients suffer from PTSD, which is usually accompanied by major psychological distress. Attention by primary-care physicians to a history of trauma could improve physicians' detection of this disabling disorder.

Prolonged Fatigue, Anxiety and Depression: Exploring Relationships in a Primary Care Sample

1999 ◽  
Vol 33 (4) ◽  
pp. 545-552 ◽  
Author(s):  
Annette Koschera ◽  
Ian Hickie ◽  
Dusan Hadzi-Pavlovic ◽  
Andrew Wilson ◽  
Andrew Lloyd
Keyword(s):  
Primary Care ◽  
Psychological Distress ◽  
Principal Component ◽  
Self Report ◽  
Anxiety And Depression ◽  
Component Solution ◽  
Two Factors ◽  
General Psychological Distress ◽  
Prolonged Fatigue ◽  
Treatment Research

Objective: While prolonged fatigue states are frequently comorbid with other forms of distress, they are now the subject of independent aetiological and treatment research. The objective of this study was to use principal component analysis to clarify the relationships between proposed measures of prolonged fatigue and anxiety and depression in data obtained from patients attending primary care. Method: Self-report measures of prolonged fatigue and psychological distress (anxiety and depression) were administered to consecutive ambulatory care patients attending primary care. Results: Data from 1593 subjects were obtained. A two-factor principal component solution (varimax rotation) demonstrated a clear separation between fatigue-related items (Cronbach's α = 0.81) as compared with those items describing anxiety and/or depression (Cronbach's α = 0.95). A four-factor solution produced similar results with two factors describing general psychological distress (contrasting anxiety and depression), with two other factors describing the profiles of mental and physical fatigue. Conclusions: The results lend weight to the argument that prolonged fatigue states can be measured independently of conventional notions of anxiety and depression in patients attending primary care. Epidemiological, aetiological and treatment research in psychiatry may need to focus greater attention on such prolonged fatigue states.

scholarly journals Preliminary Results of MyCog, a Brief Assessment for the Detection of Cognitive Impairment in Primary Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 259-260
Author(s):  
Laura Curtis ◽  
Lauren Opsasnick ◽  
Julia Yoshino Benavente ◽  
Cindy Nowinski ◽  
Rachel O’Conor ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Aging ◽  
False Positive ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Self Report ◽  
Card Sorting ◽  
Primary Care Settings

Abstract Early detection of Cognitive impairment (CI) is imperative to identify potentially treatable underlying conditions or provide supportive services when due to progressive conditions such as Alzheimer’s Disease. While primary care settings are ideal for identifying CI, it frequently goes undetected. We developed ‘MyCog’, a brief technology-enabled, 2-step assessment to detect CI and dementia in primary care settings. We piloted MyCog in 80 participants 65 and older recruited from an ongoing cognitive aging study. Cases were identified either by a documented diagnosis of dementia or mild cognitive impairment (MCI) or based on a comprehensive cognitive battery. Administered via an iPad, Step 1 consists of a single self-report item indicating concern about memory or other thinking problems and Step 2 includes two cognitive assessments from the NIH Toolbox: Picture Sequence Memory (PSM) and Dimensional Change Card Sorting (DCCS). 39%(31/80) participants were considered cognitively impaired. Those who expressed concern in Step 1 (n=52, 66%) resulted in a 37% false positive and 3% false negative rate. With the addition of the PSM and DCCS assessments in Step 2, the paradigm demonstrated 91% sensitivity, 75% specificity and an area under the ROC curve (AUC)=0.82. Steps 1 and 2 had an average administration time of <7 minutes. We continue to optimize MyCog by 1) examining additional items for Step 1 to reduce the false positive rate and 2) creating a self-administered version to optimize use in clinical settings. With further validation, MyCog offers a practical, scalable paradigm for the routine detection of cognitive impairment and dementia.

scholarly journals Sources of psychological distress among primary care physicians during the COVID-19 pandemic’s first wave in Spain: a cross-sectional study

2021 ◽  
Vol 22 ◽  
Author(s):  
Ana Cebrián-Cuenca ◽  
José Joaquín Mira ◽  
Elena Caride-Miana ◽  
Antonio Fernández-Jiménez ◽  
Domingo Orozco-Beltrán
Keyword(s):  
Primary Care ◽  
Psychological Distress ◽  
Primary Care Physicians ◽  
Linear Regression Analysis ◽  
Cross Sectional Study ◽  
Multivariate Linear Regression Analysis ◽  
Sectional Study ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Protective Measures

Abstract Background: The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. Objectives: This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). Methods: A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the ‘Self-applied Acute Stress Scale’ (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. Results: In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (−0.77 (−1.52, −0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. Conclusions: A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.

scholarly journals Hepatitis C Virus Testing Perspectives Among Primary Care Physicians in Four Large Primary Care Settings

2014 ◽  
Vol 16 (2) ◽  
pp. 256-263 ◽  
Author(s):  
Amy Jewett ◽  
Arika Garg ◽  
Katherine Meyer ◽  
Laura Danielle Wagner ◽  
Katherine Krauskopf ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Primary Care Physicians ◽  
Primary Care Settings ◽  
Large Primary ◽  
Virus Testing

scholarly journals Development of the RMT20, a composite screener to identify common mental disorders

BJPsych Open ◽  
2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Philip J. Batterham ◽  
Matthew Sunderland ◽  
Natacha Carragher ◽  
Alison L. Calear
Keyword(s):  
Psychological Distress ◽  
Anxiety Disorder ◽  
Mental Disorders ◽  
Large Scale ◽  
Common Mental Disorders ◽  
Area Under The Curve ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Epidemiological Surveys ◽  
General Psychological Distress

Background There are few very brief measures that accurately identify multiple common mental disorders. Aims The aim of this study was to develop and assess the psychometric properties of a new composite measure to screen for five common mental disorders. Method Two cross-sectional psychometric surveys were used to develop (n = 3175) and validate (n = 3620) the new measure, the Rapid Measurement Toolkit-20 (RMT20) against diagnostic criteria. The RMT20 was tested against a DSM-5 clinical checklist for major depression, generalised anxiety disorder, panic disorder, social anxiety disorder and post-traumatic stress disorder, with comparison with two measures of general psychological distress: the Kessler-10 and Distress Questionnaire-5. Results The area under the curve for the RMT20 was significantly greater than for the distress measures, ranging from 0.86 to 0.92 across the five disorders. Sensitivity and specificity at prescribed cut-points were excellent, with sensitivity ranging from 0.85 to 0.93 and specificity ranging from 0.73 to 0.83 across the five disorders. Conclusions The RMT20 outperformed two established scales assessing general psychological distress, is free to use and has low respondent burden. The measure is well-suited to clinical screening, internet-based screening and large-scale epidemiological surveys.

scholarly journals Abusive experiences and psychiatric morbidity in women primary care attenders

2003 ◽  
Vol 183 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Jeremy Coid ◽  
Ann Petruckevitch ◽  
Wai-Shan Chung ◽  
Jo Richardson ◽  
Stirling Moorey ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Substance Misuse ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Health Measures ◽  
Post Traumatic ◽  
Mental Health Effects

BackgroundAbusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.AimsTo measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.MethodA cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.ResultsChildhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.ConclusionsAbuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.

A Web Based Education Program in Adolescent Depression and Suicide for Primary Care Physicians

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Kutcher
Keyword(s):  
Primary Care ◽  
Education Program ◽  
Primary Care Physicians ◽  
Educational Program ◽  
Adolescent Depression ◽  
Web Based ◽  
Primary Care Settings ◽  
Care Intervention ◽  
Clinical Tools ◽  
Web Based Education

Adolescent depression and suicide are two important and related issues that can be effectively addressed by primary care physicians who have received appropriate training which includes the use of simple clinical tools that can be applied in usual primary care settings. This presentation reviews the evidence pertaining to primary care intervention for adolescent depression and suicide and provides a detailed description of a new Canadian web-based educational program for primary care physicians in the domain of adolescent depression and suicide.

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