scholarly journals Accuracy of general practitioner's prognosis of the 1-year course of depression and generalised anxiety

2001 ◽  
Vol 178 (1) ◽  
pp. 18-22 ◽  
Author(s):  
Rob H. S. Van Den Brink ◽  
Johan Ormel ◽  
Klaas Van Der Meer ◽  
Bea G. Tiemens ◽  
Titus W. D. P. Van Os ◽  
...  
Keyword(s):  
Primary Care ◽  
Anxiety Disorder ◽  
Mental Disorders ◽  
Statistical Model ◽  
General Practitioners ◽  
Common Mental Disorders ◽  
Generalised Anxiety Disorder ◽  
Model Based ◽  
Icd 10 ◽  
Course Of Depression

BackgroundA prognosis serves important functions for the management of common mental disorders in primary care.AimsTo establish the accuracy of the general practitioner's (GP) prognosis.MethodThe agreement between GP prognosis and observed course was determined for 138 cases of ICD–10 depression and 65 of generalised anxiety disorder, identified among consecutive attenders of 18 GPs.ResultsModest agreement between GP prognosis and course was found, both for depression (κ=0.21) and generalised anxiety (κ=0.111). Better agreement (κ=0.45 for depression, and κ=0.33 for generalised anxiety) was observed between the course and predictions from a statistical model based on information potentially available to the GP at the time the prognosis was made. This model assesses attainable performance for GPs.ConclusionsGeneral practitioners do a fair job in predicting the 1-year course of depression and generalised anxiety. Even so, their performance falls significantly short of attainable performance.

scholarly journals Lay health worker led intervention for depressive and anxiety disorders in India: impact on clinical and disability outcomes over 12 months

2011 ◽  
Vol 199 (6) ◽  
pp. 459-466 ◽  
Author(s):  
Vikram Patel ◽  
Helen A. Weiss ◽  
Neerja Chowdhary ◽  
Smita Naik ◽  
Sulochana Pednekar ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Anxiety Disorders ◽  
Suicidal Behaviour ◽  
Common Mental Disorders ◽  
Stepped Care ◽  
Psychological Morbidity ◽  
Public Facilities ◽  
Care Facilities ◽  
Icd 10

BackgroundDepressive and anxiety disorders (common mental disorders) are the most common psychiatric condition encountered in primary healthcare.AimsTo test the effectiveness of an intervention led by lay health counsellors in primary care settings (the MANAS intervention) to improve the outcomes of people with common mental disorders.MethodTwenty-four primary care facilities (12 public, 12 private) in Goa (India) were randomised to provide either collaborative stepped care or enhanced usual care to adults who screened positive for common mental disorders. Participants were assessed at 2, 6 and 12 months for presence of ICD-10 common mental disorders, the severity of symptoms of depression and anxiety, suicidal behaviour and disability levels. All analyses were intention to treat and carried out separately for private and public facilities and adjusted for the design. The trial has been registered with clinicaltrials.gov (NCT00446407).ResultsA total of 2796 participants were recruited. In public facilities, the intervention was consistently associated with strong beneficial effects over the 12 months on all outcomes. There was a 30% decrease in the prevalence of common mental disorders among those with baseline ICD-10 diagnoses (risk ratio (RR) = 0.70, 95% CI 0.53–0.92); and a similar effect among the subgroup of participants with depression (RR = 0.76, 95% CI 0.59–0.98). Suicide attempts/plans showed a 36% reduction over 12 months (RR = 0.64, 95% CI 0.42–0.98) among baseline ICD-10 cases. Strong effects were observed on days out of work and psychological morbidity, and modest effects on overall disability. In contrast, there was little evidence of impact of the intervention on any outcome among participants attending private facilities.ConclusionsTrained lay counsellors working within a collaborative-care model can reduce prevalence of common mental disorders, suicidal behaviour, psychological morbidity and disability days among those attending public primary care facilities.

E-health responses to common mental disorders in primary care: experiences with Ębeyondblue‘ and ĘSPHERE’

2002 ◽  
Vol 10 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Ian Hickie ◽  
Tracey Davenport ◽  
Elizabeth Scott ◽  
Hugh Morgan
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Health Systems ◽  
General Practitioners ◽  
Support System ◽  
Common Mental Disorders ◽  
Web Based

Objective: To highlight opportunities for enhancing mental health services in primary care through utilisation of e-health systems. Specifically, an information-based website (provided by ‘beyondblue: the national depression initiative’) and a web-based support system for general practitioners (provided by ‘SPHERE: a national depression project’) are described. Conclusions: Recommendations regarding potential roles for e-health systems in association with Australian primary care are outlined.

The Classification of Mental Disorders in Primary Care: A Guide through a Difficult Terrain

1998 ◽  
Vol 28 (2) ◽  
pp. 159-176 ◽  
Author(s):  
Henk Lamberts ◽  
Kathryn Magruder ◽  
Roger G. Kathol ◽  
Harold A. Pincus ◽  
Inge Okkes
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Primary Care Physicians ◽  
Common Mental Disorders ◽  
Classification Systems ◽  
Somatization Disorder ◽  
Icd 10 ◽  
Dsm Iv ◽  
Difficult Terrain ◽  
Clinical Comparability

Background: Primary care physicians traditionally have a strong interest in the mental health of their patients. Three classification systems are available for them to diagnose, label, and classify mental disorders: 1) The ICD-10 approach with three options, 2) The DSM-IV approach with two options, and 3) the ICPC approach with two options. This article lists important similarities and differences between the systems to help potential users choose the option that best meets their needs. Methods: Definitions for depressive disorder, anxiety disorder, and somatization disorder are compared on five characteristics of classification: 1. the domain, 2. the scope, 3. the nature of the definitions, 4. focus on episodes of care, and 5. clinical guidelines. Results: Primary care physicians and psychiatrists have different perspectives, reflected in different classifications. Each system has specific possibilities and limitations with regard to the diagnosis of mental disorders. For common mental disorders it is possible, however, to choose codes from one system while maintaining compatibility with the other two. Comparability as to the diagnostic content of the different classes, however, is more difficult to establish. The available classification systems give both primary care physicians and psychiatrists options to diagnose, label, and to classify mental disorders from their own perspective, but once a system has been chosen the clinical comparability of a patient with the same diagnosis in other systems is limited. Conclusion: Compatibility among systems can be optimized by strictly following a number of rules. The conversion between ICPC and ICD-10 (and consequently DSM-IV) allows simultaneous use of ICPC and ICD-10 as a classification and DSM-IV as the standard nomenclature. This is of particular interest for computer based patient records in primary care. The clinical comparability of the same diagnosis in different systems however is limited by the characteristics of the different system.

The reliability of a brief diagnostic interview, the trips, for the assessment of psychiatric disorders according to ICD-10 in primary care and non-psychiatric medical settings

2011 ◽  
Vol 26 (S2) ◽  
pp. 867-867 ◽  
Author(s):  
P. Berger ◽  
I. Sibitz ◽  
M. Freidl ◽  
A. Topitz ◽  
H. Katschnig
Keyword(s):  
Primary Care ◽  
Anxiety Disorder ◽  
Mental Disorders ◽  
Mood Disorder ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Diagnostic Interview ◽  
Psychiatric Training ◽  
Related Disorder ◽  
Icd 10

IntroductionAlthough there are instruments for the assessment of DSM-IV mental disorders in primary care, there is no brief instrument to assess mental disorders in primary care according to the ICD-10.AimsThe aim of the study was to assess the reliability of a new diagnostic interview, the TRIPS, designed for the assessment of anxiety-, mood-, and alcohol related disorders according to ICD-10 by non-mental health professionals.MethodsAt first, all Patients completed a screening questionnaire and were subsequently assessed by the staff of somatic departments of a Vienna General Hospital with the TRIPS. Within a week, patients were re-assessed by psychiatrists of the department of psychiatry with the Composite International Diagnostic Interview (CIDI).ResultsFinally, 290 patients could be assessed with both instruments. With the CIDI, 106 out of 290 patients (37%) got any diagnosis of a mental disorder, 74 (26%) had a mood disorder, 64 (22%) an anxiety disorder and 10 patients (3%) an alcohol-related disorder.Sensitivity of the TRIPS was 88%, specificity was 76% and diagnostic accuracy was 80% for any disorder, and 88%, 83%, and 84% respectively for any mood disorder, 72%, 88%, and 84% for any anxiety disorder, and 60%, 98%, and 97% for alcohol related disorders.ConclusionsThe results show that the TRIPS is a useful instrument with sufficient reliability to detect anxiety disorders and mood disorders in patients with somatic disorders by health professionals without psychiatric training. Due to the low base rate the test criteria for alcohol-related disorders cannot be interpreted sufficiently.

scholarly journals ROLE OF BHRAMARI PRANAYAMA IN GENERALISED ANXIETY DISORDER

2021 ◽  
Vol 5 (04) ◽  
Author(s):  
Dr. Ketaki Hemant Patil Dr. Ketaki Hemant Patil
Keyword(s):  
Mental Health ◽  
Anxiety Disorder ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Google Scholar ◽  
Generalised Anxiety Disorder ◽  
Physical And Mental Health

Pranayama is a Yogic technique which ensure homeostasis between physical and mental health. Bhramari is one of the 8 types of Pranayama as explained by Sage Patanjali which is considered to be effective in maintaining mental health. The following article discusses the probable use of Bhramari in Generalised Anxiety Disorder (GAD). Various publications from Pubmed, Google Scholar, Scopus etc were reviewed to reinforce the hypothesis that Bhramari can be effective in GAD. It is worthwhile known that Bhramari is effective in various stressful conditions but its efficacy against GAD is not yet proven. Since GAD is one of the most common mental disorders, it is hypothesised that Bhramari acts good against GAD too. Hence, it can be concluded that it would be beneficial to conduct larger studies on GAD patients to ascertain the efficacy of Bhramari in their population.

scholarly journals Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires

2007 ◽  
Vol 38 (2) ◽  
pp. 221-228 ◽  
Author(s):  
V. Patel ◽  
R. Araya ◽  
N. Chowdhary ◽  
M. King ◽  
B. Kirkwood ◽  
...  
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
General Health Questionnaire ◽  
Diagnostic Interview ◽  
Systematic Sampling ◽  
Health Questionnaire ◽  
Primary Care Settings ◽  
Self Reporting Questionnaire ◽  
Distress Scale

BackgroundScreening of patients for common mental disorders (CMDs) is needed in primary-care management programmes. This study aimed to compare the screening properties of five widely used questionnaires.MethodAdult attenders in five primary-care settings in India were recruited through systematic sampling. Four questionnaires were administered, in pairs, in random order to participants: the General Health Questionnaire (GHQ, 12 items); the Primary Health Questionnaire (PHQ, nine items); the Kessler Psychological Distress Scale (K10, 10 items), and from which we could extract the score of the shorter 6-item K6; and the Self-Reporting Questionnaire (SRQ, 20 items). All participants were interviewed with a structured lay diagnostic interview, the Revised Clinical Interview Schedule (CIS-R).ResultsComplete data were available for 598 participants (participation rate 99.3%). All five questionnaires showed moderate to high discriminating ability; the GHQ and SRQ showed the best results. All five showed moderate to high degrees of correlation with one another, the poorest being between the two shortest questionnaires, K6 and PHQ. All five had relatively good internal consistency. However, the positive predictive value (PPV) of the questionnaires compared with the diagnostic interview ranged from 51% to 77% at the optimal cut-off scores.ConclusionsThere is little difference in the ability of these questionnaires to identify cases accurately, but none showed high PPVs without a considerable compromise on sensitivity. Hence, the choice of an optimum cut-off score that yields the best balance between sensitivity and PPV may need to be tailored to individual settings, with a higher cut-off being recommended in resource-limited primary-care settings.

scholarly journals Claims for sickness and disability benefits owing to mental disorders in the UK: trends from 1995 to 2014

BJPsych Open ◽  
2016 ◽  
Vol 2 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Sebastião Viola ◽  
Joanna Moncrieff
Keyword(s):  
Anxiety Disorder ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Common Mental Disorders ◽  
Disability Benefits ◽  
Common Cause ◽  
Individual Support ◽  
Government Data ◽  
The Uk

BackgroundThere is international concern about the levels of sickness and disability benefits, with mental disorders known to account for a large proportion of claims.AimsTo examine trends in sickness and disability benefits awarded for mental disorders in the UK.MethodThe researchers analysed UK Government data from 1995 to 2014.ResultsMental disorders have become the most common cause of receiving benefits, with the number of claimants rising by 103% from 1995 to 1.1 million in 2014. Claimants with other conditions fell by 35%. In 2014, 47% of claims were attributed to a mental disorder. The number of long-term claimants (claiming over 5 years) with mental disorders increased by 87% from 2000 to 2011. Two-thirds of mental disorder claimants were classified as having a depressive or anxiety disorder.ConclusionsCommon mental disorders may involve greater morbidity and social costs than usually recognised. Availability of suitable employment, as well as individual support, may be necessary to reduce benefit levels.

scholarly journals Assessing and predicting adolescent and early adulthood common mental disorders using electronic primary care data: analysis of a prospective cohort study (ALSPAC) in Southwest England

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e053624
Author(s):  
Daniel Smith ◽  
Kathryn Willan ◽  
Stephanie L Prady ◽  
Josie Dickerson ◽  
Gillian Santorelli ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Mental Disorders ◽  
Outcome Measures ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Common Mental Disorders ◽  
Free Text ◽  
Primary Care Data ◽  
Time Point

ObjectivesWe aimed to examine agreement between common mental disorders (CMDs) from primary care records and repeated CMD questionnaire data from ALSPAC (the Avon Longitudinal Study of Parents and Children) over adolescence and young adulthood, explore factors affecting CMD identification in primary care records, and construct models predicting ALSPAC-derived CMDs using only primary care data.Design and settingProspective cohort study (ALSPAC) in Southwest England with linkage to electronic primary care records.ParticipantsPrimary care records were extracted for 11 807 participants (80% of 14 731 eligible). Between 31% (3633; age 15/16) and 11% (1298; age 21/22) of participants had both primary care and ALSPAC CMD data.Outcome measuresALSPAC outcome measures were diagnoses of suspected depression and/or CMDs. Primary care outcome measure were Read codes for diagnosis, symptoms and treatment of depression/CMDs. For each time point, sensitivities and specificities for primary care CMD diagnoses were calculated for predicting ALSPAC-derived measures of CMDs, and the factors associated with identification of primary care-based CMDs in those with suspected ALSPAC-derived CMDs explored. Lasso (least absolute selection and shrinkage operator) models were used at each time point to predict ALSPAC-derived CMDs using only primary care data, with internal validation by randomly splitting data into 60% training and 40% validation samples.ResultsSensitivities for primary care diagnoses were low for CMDs (range: 3.5%–19.1%) and depression (range: 1.6%–34.0%), while specificities were high (nearly all >95%). The strongest predictors of identification in the primary care data for those with ALSPAC-derived CMDs were symptom severity indices. The lasso models had relatively low prediction rates, especially in the validation sample (deviance ratio range: −1.3 to 12.6%), but improved with age.ConclusionsPrimary care data underestimate CMDs compared to population-based studies. Improving general practitioner identification, and using free-text or secondary care data, is needed to improve the accuracy of models using clinical data.

scholarly journals Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

2019 ◽  
Vol 73 (2) ◽  
pp. 164-170
Author(s):  
Vineta Viktorija Vinogradova ◽  
Jeļena Vrubļevska ◽  
Elmārs Rancāns
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Current Knowledge ◽  
Family Physicians ◽  
Research Programme ◽  
Primary Care Settings ◽  
National Research Programme ◽  
Management Approaches ◽  
Training Programmes

Abstract Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.

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