Determinants of Common Mental Disorders Detection by General Practitioners in the Primary Health Care in Brazil

2011 ◽  
Vol 41 (1) ◽  
pp. 3-13 ◽  
Author(s):  
Daniel A. Gonçalves ◽  
Sandra Fortes ◽  
Luís Fernando Tófoli ◽  
Mônica Rodrigues Campos ◽  
Jair De Jesus Mari
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
General Practitioners ◽  
Common Mental Disorders ◽  
Psychiatric Morbidity ◽  
Physical Symptoms ◽  
Detection Accuracy ◽  
Detection Rates ◽  
Primary Health

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.

scholarly journals Common mental disorders among patients in primary health care in Greenland

2004 ◽  
Vol 63 (sup2) ◽  
pp. 377-383 ◽  
Author(s):  
Inge Lynge ◽  
Povl Munk-Jørgensen ◽  
Amalia Lynge Pedersen ◽  
Gert Mulvad ◽  
Peter Bjerregaard
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Primary Health

scholarly journals Impact of the ICD–10 Primary Health Care (PHC) diagnostic and management guidelines for mental disorders on detection and outcome in primary care

2003 ◽  
Vol 182 (1) ◽  
pp. 20-30 ◽  
Author(s):  
Tim Croudace ◽  
Jonathan Evans ◽  
Glynn Harrison ◽  
Deborah J. Sharp ◽  
Ellen Wilkinson ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Controlled Trial ◽  
General Health Questionnaire ◽  
World Health ◽  
Detection Rates ◽  
Primary Health ◽  
Icd 10 ◽  
Health Organization

BackgroundThe World Health Organization (WHO) ICD–10 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (1996) have not been evaluated in a pragmatic randomised controlled trial (RCT).AimsTo evaluate the effect of local adaptation and dissemination of the guidelines.MethodPragmatic, pair-matched, cluster RCT involving 30 practices.ResultsGuideline practices were less sensitive but more specific in identifying morbidity, but these differences were not significant. Guideline patients did not differ from usual-care patients on 12-item General Health Questionnaire scores at 3-month follow-up or in the proportion who were still cases. There were no significant differences in secondary outcomes.ConclusionsAttempts to influence clinician behaviour through a process of adaptation and extension of guidelines are unlikely to change detection rates or outcomes.

scholarly journals Adherence to clinical guidelines in integration of mental health services into primary health care in Mbarara, southwestern Uganda: a medical records review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Edith K. Wakida ◽  
Moses Ocan ◽  
Godfrey Z. Rukundo ◽  
Samuel Maling ◽  
Peter Ssebutinde ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Clinical Guidelines ◽  
Common Mental Disorders ◽  
Primary Health ◽  
Southwestern Uganda

Abstract Background The Ugandan Ministry of Health decentralized mental healthcare to the district level; developed the Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, and referral of individuals with common mental disorders. This was intended to promote integration of mental health services into PHC in the country. ‘Common mental disorders’ here refers to mental, neurological and substance use conditions as indicated in the UCG. However, the extent of integration of mental health into general healthcare remains unknown. This study aimed to establish the level of adherence of PHC providers to the UCG in the identification and management of mental disorders. Methods This was a prospective medical record review of patient information collected in November and December 2018, and March and April 2019 at two health centers (III and IV) in southwestern Uganda. Data (health facility level; sex and age of the patient; and mental disorder diagnosis, management) was collected using a checklist. Continuous data was analyzed using means and standard deviation while categorical data was analyzed using Chi-square. Multivariable logistic regression analysis was performed to establish predictors of PHC provider adherence to the clinical guidelines on integration of mental health services into PHC. The analysis was conducted at a 95% level of significance. Results Of the 6093 records of patients at the study health facilities during the study period, 146 (2.4%) had a mental or neurological disorder diagnosis. The commonly diagnosed disorders were epilepsy 91 (1.5%) and bipolar 25 (0.4%). The most prescribed medications were carbamazepine 65 (44.5%), and phenobarbital 26 (17.8%). The medicines inappropriately prescribed at health center III for a mental diagnosis included chlorpromazine for epilepsy 3 (2.1%) and haloperidol for epilepsy 1 (0.7%). Female gender (aOR: 0.52, 95% CI 0.39–0.69) and age 61+ years (aOR: 3.02, 95% CI 1.40–6.49) were predictors of a mental disorder entry into the HMIS register. Conclusion There was a noticeable change of practice by PHC providers in integrating mental health services in routine care as reflected by the rise in the number of mental disorders diagnosed and treated and entered into the modified paper based HMIS registers.

scholarly journals Factors associated with common mental disorders among female nursing professionals in primary health care

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Iracema Lua ◽  
Tânia Maria de Araújo ◽  
Kionna Oliveira Bernardes Santos ◽  
Maura Maria Guimarães de Almeida
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Factors Associated ◽  
Primary Health ◽  
Nursing Professionals

Common Mental Disorders and Primary Health Care: Current Practice in Low-Income Countries

2003 ◽  
Vol 11 (3) ◽  
pp. 166-173 ◽  
Author(s):  
Melanie Abas ◽  
Florence Baingana ◽  
Jeremy Broadhead ◽  
Eduardo Iacoponi ◽  
Jane Vanderpyl
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Low Income ◽  
Current Practice ◽  
Common Mental Disorders ◽  
Low Income Countries ◽  
Primary Health

Common mental disorders in primary health care: differences between Latin American-born and Spanish-born residents in Madrid, Spain

2014 ◽  
Vol 50 (3) ◽  
pp. 429-443 ◽  
Author(s):  
Miguel A. Salinero-Fort ◽  
Rodrigo Jiménez-García ◽  
Carmen de Burgos-Lunar ◽  
Rosa M. Chico-Moraleja ◽  
Paloma Gómez-Campelo
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mental Disorders ◽  
Latin American ◽  
Common Mental Disorders ◽  
Primary Health
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