scholarly journals Primary care psychiatry: pertinent Arabian perspectives

2005 ◽  
Vol 11 (3) ◽  
pp. 449-458
Author(s):  
O. E. El Rufaie
Keyword(s):  
Primary Care ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Validity And Reliability ◽  
Critical Approach ◽  
Primary Care Doctors ◽  
Primary Care Patients ◽  
Primary Care Practitioners ◽  
Training Programmes ◽  
And Training

There is substantive evidence of significant psychiatric morbidity among primary care patients, mainly in the form of anxiety and depressive disorders. A careful critical approach is essential for ensuring the cultural relevance, validity and reliability of the psychiatric screening instruments used to identify such morbidity. Most psychiatric morbidity among primary care patients passes undetected by the primary care practitioners. This will inevitably lead to unnecessary investigation and medication and the continuation of suffering for patients. Comorbidity and physical presentation in most instances contribute significantly to failure to detect psychiatric disorders. To deal with this problem of hidden psychiatric morbidity, carefully designed educational and training programmes need to be tailored to address the particular weaknesses and needs of primary care doctors

Depressive Disorder in Primary Care

1987 ◽  
Vol 150 (6) ◽  
pp. 737-751 ◽  
Author(s):  
C. V. R. Blacker ◽  
A. W. Clare
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Depressive Illness ◽  
Psychiatric Disturbance ◽  
Collaborative Studies ◽  
Effect Of Treatment ◽  
Precise Relationship ◽  
The Relationship

Since the pioneering study of psychiatric morbidity in primary care by Shepherdet alin 1966, it has become increasingly apparent that a substantial proportion (between 20% and 25%) of patients consulting their GP are suffering from some form of psychiatric disturbance (Goldberg & Blackwell, 1970; Hoeperet al,1979). The composition of this psychiatric morbidity has been shown to be almost wholly affective in nature and largely mild in degree. In their important review Jenkins & Shepherd (1983) recently summarised the now extensive findings relating to overall minor psychiatric morbidity in primary care. However, recent collaborative studies between psychiatrists and GPs have identified that within this dilute pool of minor disorders, lurks a significant but poorly served population of patients suffering from depressive disorders which are by no means minor in degree. A number of crucial issues regarding this depression in primary care emerge which the present paper aims to review. In particular, how common is it, and how severe? How does it present and what, if any, are its special characteristics? What is the precise relationship between depressive symptoms and depressive illness presenting to the GP and what is the relationship between physical illness and depression? And finally, what is the course and outcome of depression in this setting and what are the indications for and effect of treatment?

scholarly journals Leadership in Higher Military Educational Institutions: Models and Training Programmes

2019 ◽  
pp. 93-103
Author(s):  
Oleksandr Zaruba
Keyword(s):  
Political System ◽  
Educational Institutions ◽  
Executive Power ◽  
The Political ◽  
Critical Approach ◽  
Security Sector ◽  
Institu Tions ◽  
Training Programmes ◽  
Theoretical Foundations ◽  
And Training

The article deals with the theoretical foundations of leadership, Ukrainian historical traditions and contemporary state of practical use and teaching of leadership in military educational institu-tions with the aim to form pro-active officer cadre, with further employment in bodies of executive power and participation in the political system of the state. Key words: top military brass, high brass, transaction leadership, transforma-tional leadership, critical approach, reforms in the defense and security sector.

The diagnostic status of patients with conspicuous psychiatric morbidity in primary care

1984 ◽  
Vol 14 (3) ◽  
pp. 673-681 ◽  
Author(s):  
Patricia R. Casey ◽  
S. Dillon ◽  
P. J. Tyrer
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Personality Disorder ◽  
Mental State ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Epidemiological Studies ◽  
Detailed Assessment ◽  
One Year ◽  
Primary Problem

SynopsisA 7% one-year prevalence rate of conspicuous psychiatric morbidity was found in patients attending a single general practice. The nature of the morbidity was examined by a detailed assessment of mental state and personality, using interview schedules administered by a psychiatrist. Depressive disorders were presented by nearly half of the patients. The overall sex incidence of the disorders was equal, but alcohol abuse was more common in males. A personality disorder was present in 33·9% of all patients seen, although it was rarely diagnosed as the primary problem and was linked to the diagnosis of anxiety states, rather than depressive neurosis. These findings are discussed in relation to other epidemiological studies in primary care.

The validity and reliability of the fatigue syndrome that follows glandular fever

1995 ◽  
Vol 25 (5) ◽  
pp. 917-924 ◽  
Author(s):  
P. D. White ◽  
S. A. Grover ◽  
H. O. Kangro ◽  
J. M. Thomas ◽  
J. Amess ◽  
...  
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Depressive Disorders ◽  
Principal Component ◽  
Upper Respiratory Tract ◽  
Validity And Reliability ◽  
Glandular Fever ◽  
Fatigue Syndrome ◽  
Primary Care Patients ◽  
Upper Respiratory

SYNOPSISThe validity and reliability of an empirically defined fatigue syndrome were tested in a prospective cohort study of 245 primary care patients, with glandular fever or an upper respiratory tract infection. Subjects were interviewed three times in the 6 months after onset. Subjects with the empirically defined fatigue syndrome were compared with those who were well and those who had a psychiatric disorder.The validity of the fatigue syndrome was supported, separate from psychiatric disorders in general and depressive disorders in particular. Only 16% of subjects with the principal component derived fatigue factor also met criteria for a psychiatric disorder (excluding pre-morbid phobias). Compared with subjects with psychiatric disorders, subjects with the operationally defined fatigue syndrome reported more severe physical fatigue, especially after exertion, were just as socially incapacitated, had fewer mental state abnormalities, and showed little overlap on independent questionnaires. A more mild fatigue state also existed. Both the fatigue syndrome and state were more reliable diagnoses over time than depressive disorders. The empirically defined fatigue syndrome probably is a valid and reliable condition in the 6 months following glandular fever.

Depressive Disorders in Japanese Primary Care Patients

1994 ◽  
Vol 11 (4) ◽  
pp. 363-367 ◽  
Author(s):  
YOSHIO MINO ◽  
HIDEYASU AOYAMA ◽  
JACK FROOM
Keyword(s):  
Primary Care ◽  
Depressive Disorders ◽  
Primary Care Patients

Suicidal behaviour among primary-care patients with depressive disorders

2005 ◽  
Vol 36 (2) ◽  
pp. 203-210 ◽  
Author(s):  
M. S. VUORILEHTO ◽  
T. K. MELARTIN ◽  
E. T. ISOMETSÄ
Keyword(s):  
Primary Care ◽  
Suicidal Ideation ◽  
Personality Disorder ◽  
Depressive Disorder ◽  
Suicidal Behaviour ◽  
Depressive Disorders ◽  
Psychiatric Treatment ◽  
Central Position ◽  
Primary Care Patients ◽  
Axis I

Background. Most national suicide prevention strategies set improved detection and management of depression in primary health care into a central position. However, suicidal behaviour among primary-care patients with depressive disorders has been seldom investigated.Method. In the Vantaa Primary Care Depression Study, a total of 1119 primary-care patients in the City of Vantaa, Finland, aged 20 to 69 years, were screened for depression with the Primary Care Evaluation of Mental Disorders (PRIME-MD) questionnaire. Depressive disorders were diagnosed with the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), and the 137 patients with depressive disorder were included in the study. Suicidal behaviour was investigated cross-sectionally and retrospectively in three time-frames: current, current depressive episode, and lifetime. Current suicidal ideation was measured with the Scale for Suicidal Ideation (SSI), and previous ideation and suicide attempts were evaluated based on interviews plus medical and psychiatric records.Results. Within their lifetimes, 37% (51/137) of the patients had seriously considered suicide and 17% (23/137) attempted it. Lifetime suicidal behaviour was independently and strongly predicted by psychiatric treatment history and co-morbid personality disorder, and suicidal behaviour within the current episode was predicted most effectively by severity of depression.Conclusions. Based on these findings and their convergence with studies of completed suicides, prevention of suicidal behaviour in primary care should probably focus more on high-risk subgroups of depressed patients, including those with moderate to severe major depressive disorder, personality disorder or a history of psychiatric care. Recognition of suicidal behaviour should be improved. The complex psychopathology of these patients in primary care needs to be considered in targeting preventive efforts.

scholarly journals Response style and severity and chronicity of depressive disorders in primary health care

2016 ◽  
Vol 33 (1) ◽  
pp. 1-8
Author(s):  
K. Riihimäki ◽  
M. Vuorilehto ◽  
P. Jylhä ◽  
E. Isometsä
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Rating Scale ◽  
Response Styles ◽  
Related Phenomenon ◽  
Eysenck Personality Inventory ◽  
Primary Care Patients ◽  
Depressive Episodes

AbstractBackgroundResponse styles theory of depression postulates that rumination is a central factor in occurrence, severity and maintaining of depression. High neuroticism has been associated with tendency to ruminate. We investigated associations of response styles and neuroticism with severity and chronicity of depression in a primary care cohort study.MethodsIn the Vantaa Primary Care Depression Study, a stratified random sample of 1119 adult patients was screened for depression using the Prime-MD. Depressive and comorbid psychiatric disorders were diagnosed using SCID-I/P and SCID-II interviews. Of the 137 patients with depressive disorders, 82% completed the prospective five-year follow-up with a graphic life chart enabling evaluation of the longitudinal course of episodes. Neuroticism was measured with the Eysenck Personality Inventory (EPI-Q). Response styles were investigated at five years using the Response Styles Questionnaire (RSQ-43).ResultsAt five years, rumination correlated significantly with scores of Hamilton Depression Rating Scale (r = 0.54), Beck Depression Inventory (r = 0.61), Beck Anxiety Inventory (r = 0.50), Beck Hopelessness Scale (r = 0.51) and Neuroticism (r = 0.58). Rumination correlated also with proportion of follow-up time spent depressed (r = 0.38). In multivariate regression, high rumination was significantly predicted by current depressive symptoms and neuroticism, but not by anxiety symptoms or preceding duration of depressive episodes.ConclusionsAmong primary care patients with depression, rumination correlated with current severity of depressive symptoms, but the association with preceding episode duration remained uncertain. The association between neuroticism and rumination was strong. The findings are consistent with rumination as a state-related phenomenon, which is also strongly intertwined with traits predisposing to depression.

Identifying anxiety and depressive disorders among primary care patients: A pilot study

1988 ◽  
Vol 77 (3) ◽  
pp. 280-282 ◽  
Author(s):  
O.E.F.A. El-Rufaie ◽  
A.A. Albar ◽  
B.K. Al-Dabal
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Depressive Disorders ◽  
Primary Care Patients
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