Psychotherapeutic interventions

2017 ◽  
Author(s):  
Fiammetta Cosci ◽  
Giovanni Andrea Fava
Keyword(s):  
Primary Care ◽  
Anxiety Disorders ◽  
Clinical Judgment ◽  
Primary Care Physicians ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Somatic Symptom ◽  
Treatment Plan ◽  
Unipolar Depression ◽  
Psychotherapeutic Interventions ◽  
Primary Care Settings

Primary care physicians may offer a comprehensive care of patients having psychiatric ailments. Psychological interventions are effective in treating major depressive disorder, anxiety disorders, somatic symptom disorders, and tobacco use disorders in primary care settings. Psychotherapeutic approaches are effective either as an alternative or as an adjunct to pharmacotherapy, with enduring benefits after discontinuation of drug treatment. Psychotherapy also represents a pilot area of intervention to treat withdrawal symptoms and disorders due to the tapering or discontinuation of psychotropic medications, in particular selective serotonin reuptake inhibitors (SSRIs). This chapter illustrates the basic steps to establish routine evidence-based psychotherapy for unipolar depression, anxiety disorders, somatic symptom disorder, and substance use disorders in primary care settings. Some factors should be considered to formulate a proper treatment plan for mental disorders in primary care, including primary care physicians’ clinical judgment, availability of treatment, and patient’s preference.

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 First clinical judgment by primary care physicians distinguishes well between nonorganic and organic causes of abdominal or chest pain

1997 ◽  
Vol 12 (8) ◽  
pp. 459-465 ◽  
Author(s):  
Benedict Martina ◽  
Bruno Bucheli ◽  
Martin Stotz ◽  
Edouard Battegay ◽  
Niklaus Gyr
Keyword(s):  
Primary Care ◽  
Chest Pain ◽  
Clinical Judgment ◽  
Primary Care Physicians

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.

Management of Painful Physical Symptoms Associated With Depression and Mood Disorders

CNS Spectrums ◽  
2005 ◽  
Vol 10 (S19) ◽  
pp. 1-16 ◽  
Author(s):  
Thomas N. Wise ◽  
Lesley M. Arnold ◽  
Vladimir Maletic ◽  
David L. Ginsberg
Keyword(s):  
Primary Care ◽  
Neuropathic Pain ◽  
Mood Disorders ◽  
Primary Care Physicians ◽  
Depressive Disorders ◽  
Pain Perception ◽  
Antidepressant Treatment ◽  
Physical Symptoms ◽  
Emotional Symptoms ◽  
Primary Care Settings

AbstractDepression is a common, recurring illness that continues to be underdiagnosed and undertreated in both psychiatric and primary care settings. It is increasingly being recognized that painful physical symptoms, which commonly exist comorbid with depressive disorders, play a role in complicating diagnosis of depression. Patients tend to discuss physical pain with primary care physicians and emotional pain with psychiatrists, often oblivious to the fact that both may be aspects of one disorder. Those who present with somatic complaints are three times less likely to be accurately diagnosed than patients with psychosocial complaints. However, thorough evaluation of mood and anxiety disorders in primary care is sparse due to the limited time primary care physicians can spend with each patient. Better recognition and treatment of both physical and emotional symptoms associated with mood disorders may increase a patient's chance of achieving remission, which is the optimum therapeutic goal.Abnormalities of serotonin and noradrenaline are strongly associated with depression and are thought to play a role in pain perception. Brain-derived neurotrophic factor, which is increased with antidepressant treatment, appears to influence regulation of mood and perception of pain. Clinical evidence indicates that dual-acting agents may have an advantage in modulating pain over those agents that increase either serotonin or noradrenaline alone. The novel dual-acting agents, such as venlafaxine and duloxetine, are better tolerated than tricyclic antidepressants and monoamine oxidase inhibitors. These agents have demonstrated efficacy in depression and in diabetic neuropathic pain independently. Therefore, unless otherwise stated, all inferences to studies of pain in this monograph refer to neuropathic pain in nondepressed patients.

Detection and management of mental distress and psychiatric disorders in primary care settings

1999 ◽  
Vol 8 (2) ◽  
pp. 92-104 ◽  
Author(s):  
Stefano Pini ◽  
Michele Tansella
Keyword(s):  
Primary Care ◽  
Psychiatric Disorders ◽  
Primary Care Physicians ◽  
Social Impact ◽  
Mental Distress ◽  
Mental Illnesses ◽  
Clinical Activity ◽  
Primary Care Settings ◽  
Number Of Factors ◽  
Specialist Services

SummaryObjective – Epidemiological and clinical studies indicate that 10–50% of primary care patients suffering from clinically relevant psychiatric distress are not diagnosed by their physician and only a minority of them receive an appropriate treatment. The improvement of physicians' ability to detect mental distress and psychiatric disorder, in their routine clinical activity, represents a crucial point to reduce the social impact of mental illnesses, prevent their worsening and chronicity and, eventually, relieve mental health services of an excessive burden of care and costs. The aim of this article is to examine a number of factors which intervene in the process of detection of mental distress by the physician. Then, we will examine factors related to the management of psychiatric disorders most commonly co-occurring with physical illness in general health care sector. Method – The method used for this review was essentially a recension of the literature concerning detection and treatment of psychiatric disorders in primary care settings, having in view to see the factors connected with these processes. Results – Among factors intervening in the process of identification of mental distress in primary care settings, both the characteristics of the physician and the characteristics of the patient should be taken into account. Primary care physicians and psychiatrists are being asked to work together more frequently in this era of community care. The principal aim of such invoked collaboration is the amelioration of quality of care and reduction of costs for mentally ill patients. An important issue within this collaboration is the referral by primary care physicians to specialist services.

Anxiety Disorders in Primary Care Settings

2019 ◽  
Vol 54 (4) ◽  
pp. 473-493 ◽  
Author(s):  
Ashley S. Love ◽  
Rene Love
Keyword(s):  
Primary Care ◽  
Anxiety Disorders ◽  
Primary Care Settings

The Prevalence of Late-Lifedepression and Physicians’ Attitude Toward it in Primary Care Settings of China

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
S. Chen
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Older People ◽  
Primary Care Physicians ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Late Life ◽  
Well Being ◽  
Late Life Depression ◽  
Primary Care Settings

Late-life depression is associated with physical and psychological comorbidity, functional and cognitive impairment, and increased mortality due to suicide and other causes. However, studies in the west show that the identification of depression in older people is problematic and consequently the illness is underdiagnosed and undertreated. We investigated the prevalence of late-life depression and physicians’ attitude toward it in primary care settings of China.The survey was performed in urban primary care settings of Hangzhou, China. 1000 patients aged ≥ 55 years and 300 primary care physicians were recruited, of which 689 patients and 247 physicians provided complete data. The Geriatric Depression Scale (GDS-30) was used for investigating the prevalence of late-life depression in patients, and the Depression Attitude Questionnaire (DAQ) for investigating physicians’ attitudes and knowledge about depression.Of the 689 patients, 23.4% (n=161) scored ≥ 11 on the GDS-30, including 3% (n=21) who scored ≥ 21. Among the physicians, 72% (n=178) endorsed that “Becoming depressed is a natural part of being old”, and 70% (n=173) of them thought “Working with depressed patients is heavy going”; in their clinical practice. Only 6.6% of physicians prescribed anti-depressants.Primary care physicians in China are ill prepared to diagnose and treat depression in older adults, which presents at high rates in primary care clinics. How to improve their attitudes and clinical practice is crucial to the well-being of older people in China.

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