The ability of general practitioners to detect mental disorders in primary health care

Objective: Common Mental Disorders (CMD) are highly prevalent among patients attending primary care. Many of these disorders remain unrecognized by general practitioners (GPs), with the detection rates varying from 30 to 60%. This study aims to evaluate the CMD detection rates by Primary Heath Care (PHC) practitioners in Brazil—and factors that affect CMD detection. Methods: A cross sectional study was conducted with users of five PHC units in the city of Petrópolis. The CMD prevalence of psychiatric morbidity was estimated by the General Health Questionnaire-12, and the physician's CMD detection was evaluated by a questionnaire completed by GPs after each consultation. Results: Seven hundred and fourteen subjects participated of the study, and 400 (56%) were screened positive using GHQ-12 cut-off point of 2/3. GPs diagnosed 379 people with CMD (53.1%), and 256(36%) subjects were detected by both GHQ and the GPs with an OR of 3.04 (95%CI 2.23–4.13). CMD detection accuracy by GPs was 65%. There was a strong association between the detection of CMD and the report of medically unexplained physical symptoms by GPs. Being female, married, and a frequent service user was also related to higher detection rates. Conclusion: CMD detection rate was similar to those reported worldwide, but contrary to other studies, the presence of MUS increased detection rates. The high frequency of CMD in Primary Health Care highlights the need for improving GP and health worker's training in order to enable them to accurately recognize and treat psychological distress with evidence-based interventions.

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Professional competencies of primary health care physicians in evaluating the mental health of patients. Part 1. The relevance of expanding the competencies of general practitioners in rendering care to patients with concomitant mental disorders

Profilakticheskaya meditsina ◽

10.17116//profmed20192206134 ◽

2019 ◽

Vol 22 (6) ◽

pp. 34

Author(s):

T. V. Dovzhenko ◽

A. E. Bobrov ◽

Yu. A. Vasyuk ◽

E. G. Starostina

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

General Practitioners ◽

Professional Competencies ◽

Primary Health ◽

Primary Health Care Physicians

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Agreement on diagnoses of mental disorder in the primary health care of Turku, Finland

European Psychiatry ◽

10.1016/0767-399x(96)80070-8 ◽

1995 ◽

Vol 10 (1) ◽

pp. 11-16 ◽

Cited By ~ 9

Author(s):

V Lehtinen ◽

M Joukamaa ◽

H Karlsson ◽

E Rouhe

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

Mental Disorder ◽

General Practitioners ◽

Health Centre ◽

Mental Health Issue ◽

Psychiatric Interview ◽

Primary Health

SummaryPrimary health care is in the central position in the general sphere of mental health services. This article deals with, as a part of a joint Nordic project, the occurrence of mental disorders of patients in primary health care as based on the material (n = 1,000) collected in the health centre of Turku. The relation of the occurrence of mental disorders as diagnosed by means of a standardized psychiatric interview method (PSE) to the disorders, recognized by general practitioners (GPs) working in the health centre is also observed. It was found that one fourth of the patients had a clear mental disorder that required treatment, while studies in the general population, using the same method, reveal only 10% as having some kind of mental disorder. Three quarters of the evident mental disorders recognized by GPs were diagnosed as such also by the PSE, but the GPs were capable of recognizing only 43% of the cases identified by the PSE. On the basis of these results, the importance of the mental health issue in the basic and postgraduate training of the general practitioners must be emphasized.

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Dilemmas at a Primary Health Care Center: a baseline study for Computer-Supported Cooperative Health Care Work

Methods of Information in Medicine ◽

10.1055/s-0038-1634874 ◽

1992 ◽

Vol 31 (03) ◽

pp. 204-209 ◽

Cited By ~ 7

Author(s):

T. Timpka ◽

J. M. Nyce

Keyword(s):

Health Care ◽

Primary Health Care ◽

General Practitioners ◽

Group Process ◽

Critical Incident ◽

Care Work ◽

Work Activity ◽

Health Care Center ◽

Health Care Work ◽

Primary Health

Abstract:For the development of computer-supported cooperative health care work this study investigated, based upon activity theory, daily dilemmas encountered by the members of interprofessional primary health care work groups. The entire staff at four Swedish primary health care centers were surveyed, 199 personal interviews being conducted by the Critical Incident Technique. Medical dilemmas were mainly reported by general practitioners and nurses, organizational dilemmas by laboratory staff, nurses’ aides, and secretaries, and dilemmas in the patient-provider relation by nurses, nurses’ aides, and secretaries. Organizational and communication dilemmas reported by nurses, nurses’ aides, and secretaries often had their cause outside the control of the individual professional. These dilemmas were often “caused” by other group members (general practitioners or nurses), e.g., by not keeping appointment times or by not sharing information with patients. The implication for computer-supported cooperative health care work is that computer support should be planned on two levels. Collective work activity as a whole should benefit from individual clinical decision support for general practitioners and nurses. However, since most patient communication and organizational problems occurred at group level, group process support is required in these areas.

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Primary Health Care and the ICD-11

Die Psychiatrie ◽

10.1055/s-0038-1670835 ◽

2013 ◽

Vol 10 (01) ◽

pp. 33-37 ◽

Cited By ~ 2

Author(s):

M. Klinkman ◽

D. Goldberg

Keyword(s):

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

Medical Care ◽

Special Needs ◽

Field Trials ◽

Primary Medical Care ◽

Dsm 5 ◽

Primary Health ◽

Icd 10

SummaryThis paper describes the necessity of adapting the major classifications of mental disorders exemplified by the ICD-11 and the DSM-5 for the special needs of primary medical care. An earlier version of the classification – the ICD-10-PHC – is described, and the process of adapting it is described in detail. The new 28 item version of the classification is described, and the procedures to be adopted in the Field Trials to be held during 2013 are set out, together with the specific problems these field trials will address.

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The wicked problem of delivering primary health care to people with intellectual disabilities. Commentary on “Attitudes and experiences of general practitioners who provided health care for people with intellectual disabilities: a South Australian perspective” (Smith & Laurence, 2021)

Research and Practice in Intellectual and Developmental Disabilities ◽

10.1080/23297018.2021.1910987 ◽

2021 ◽

pp. 1-9

Author(s):

Teresa Iacono

Keyword(s):

Health Care ◽

Primary Health Care ◽

Intellectual Disabilities ◽

General Practitioners ◽

Wicked Problem ◽

Primary Health ◽

People With Intellectual Disabilities

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Childhood Mental Disorders in Primary Health Care: Results of Observations in Four Developing Countries

PEDIATRICS ◽

10.1542/peds.68.5.677 ◽

1981 ◽

Vol 68 (5) ◽

pp. 677-683

Author(s):

R. Giel ◽

M. V. de Arango ◽

C. E. Climent ◽

T. W. Harding ◽

H. H. A. Ibrahim ◽

...

Keyword(s):

Health Care ◽

Developing Countries ◽

Primary Health Care ◽

Mental Disorders ◽

Health Workers ◽

Health Care Facilities ◽

Primary Health ◽

Care Facilities ◽

Research Procedure ◽

Primary Health Care Facilities

To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Colombia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to that encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The results have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.

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