scholarly journals Modern approaches to the diagnosis and treatment of mixed anxiety-depressive disorders in primary health care

2021 ◽  
Vol 5-6 (215-216) ◽  
pp. 53-62
Author(s):  
Natalya Raspopova ◽  
◽  
Maria Dzhamantayeva ◽  
Yerbol Nurkatov ◽  
Laila Uteniyazova ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Practice ◽  
Depressive Disorders ◽  
Anxiety And Depression ◽  
Outpatient Basis ◽  
General Medical Practice ◽  
Symptoms Of Depression ◽  
Clinical Observations ◽  
Primary Health

The relevance of this work is due to the wide prevalence of mixed anxiety-depressive disorders among general medical practice patients. At the present stage of development of the psychiatric service in the Republic of Kazakhstan, a new concept has been developed that assumes the transfer of a number of borderline mixed anxiety-depressive disorders to the competence of PHC doctors with the need for their treatment with modern antidepressants. The purpose of this work. Development and implementation in general clinical practice of modern methods of diagnosis and treatment of mixed anxiety-depressive disorders. Material and methods. 30 patients with mixed anxiety-depressive disorders of the borderline level, who were treated on an outpatient basis (Nursultan) was examined. The study was conducted using international psychometric scales: Hospital Anxiety and Depression Score (HADS), Hamilton Anxiety and Depression Rating Scale (HDRS, HAM-A). Results and discussion. As a result of the study, it was found that among patients with mixed anxiety-depressive disorders who were treated on an outpatient basis, young people of working age from 21 to 50 years (83.3%) prevailed, in whom psychogenic anxiety-depressive disorders accounted for 60%. In the course of clinical observations, objective data were obtained indicating that when treating depressive states of mild and moderate severity with Mianserin drug on an outpatient basis, by the end of the second week of treatment, there is a fairly pronounced positive dynamics in the reduction of symptoms of depression. By the end of the second month of taking this drug (8 weeks), most patients had no symptoms of depression. Conclusions. Practical clinical observations have shown that the modern Mianserin antidepressant, possessing a wide range of clinical effects combining thymoanaleptic action proper with anti-anxiety, sedative and hypnotic effects is well tolerated by patients and can be recommended for widespread use in the treatment of mixed anxiety-depressive disorders in general medical practice. Keywords: depression, anxiety, primary health care, general medical practice, antidepressants.

scholarly journals The Training of Undergraduate Medical Students in General Medical Practice and Primary Health Care: A Scoping Review

2021 ◽  
Vol 14 (1) ◽  
pp. 555-570
Author(s):  
Langalibalele Honey Mabuza ◽  
Gabriel Gyang Darong ◽  
Sbongile Joyce Makhudu ◽  
Roisin E. Drysdale ◽  
Mosa Moshabela
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Students ◽  
Medical Practice ◽  
Scoping Review ◽  
Medical Training ◽  
Undergraduate Medical Students ◽  
General Medical Practice ◽  
Primary Health ◽  
Pedagogical Approaches

Background: Undergraduate medical students are trained to acquire a general medical practice overview on qualifying. This training forms a foundation for primary health care service or further training towards a specialty of choice. Objective: The aim of the study was to determine the scope of published scientific literature on the training of undergraduate medical students in “general medical practice” and “primary health care,” exploring how these two concepts are understood, the pedagogical approaches employed by the trainers, the training platforms and the challenges encountered during the training. Methods: The review followed the five steps recommended by Arksey and O’Malley. Using the specified eligibility criteria, the research team systematically screened titles, abstracts, and full articles. Data were entered into Google Forms spreadsheets, which was followed by inductive data analysis of key themes. Results: 130 articles were eligible for inclusion in the study. Thematic analysis yielded eight themes: definition of “general medical practice” and “PHC”, pedagogical approaches (conventional, PBL, teams and CBME), training platforms (tertiary and rural), medical students’ trainers (faculty, GPs and patients), training content, trainers’ and trainees’ perceptions, and challenges encountered. Conclusion: This scoping review has revealed that general medical practice and primary health care are approaches to holistic patient care taught at undergraduate medical training. Primary health care and general medical training are mainly undertaken in GP practices and rural settings. Competency-based medical education is emerging as an appropriate pedagogical method towards ‘fit-for-purpose’ training. The inclusion of patients as trainers in general medical practice and primary health care is yielding positive results.

scholarly journals Mental health in primary health care: professionals’ perceptions and patients’ levels of depression, anxiety and stress

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tatiana Varela Madureira ◽  
Maria Cristina Quintas Antunes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Anxiety And Depression ◽  
Self Administration ◽  
Primary Health

Background: The integration of mental health in primary health care, throughout its various functional units and with effective articulation between primary health care and mental health services, has been considered an essential objective of the legislative documents produced in the last three decades in Portugal, among them the National Health Plan 2011-2016.Goals: This study aimed to inquire health professionals’ perceptions about mental health care provided by public primary health care units, namely their perceptions about the mental health of their patients. It also intended to explore the difficulties perceived by the health professionals in their daily activity about the mental health problems of their patients and about the need of clinical psychologists’ activity in the public primary health care.Methods: This is an observational cross-sectional study with two non-probabilistic samples: health professionals (doctors, nurses and psychologists) and patients from two public health care units. Health professionals were interviewed (individual structured face-to-face interviews) about their perceptions of needs for improving their capacity to provide mental healthcare and about patients’ mental health conditions. Patients responded (by self-administration) to the Depression, Anxiety and Stress Scale (DASS-21), providing a characterization of patients’ stress, anxiety and symptoms of depression.Results: Health professionals in their daily practice often identify in their patients symptoms of stress, anxiety and depression (most particularly in adults),. Several issues were identified as problematic, such as: poor access of the referral system for psychiatric and clinical psychological specialized care, insufficient number of health professionals, particularly of psychologists, and lack of appropriate mental health care specialization. The results also revealed relevant levels of stress, anxiety and depression in primary health care patients (both genders), which seem to increase with age. Discussion: Difficulties identified by health professionals may relate to the centralisation of resources, resistance to change from human resources management, lack of consensus among the various decision groups linked to mental health and, at institutional level, insufficient and inadequate funding. These factors may contribute to a failure in early diagnosis of symptoms of depression, anxiety and stress. It is expected that articulation between primary health services and differentiated health services will improve, with improvement in teamwork among professionals and increase of the quality of life of users, satisfaction with work, from health professionals,  and reduction of health costs.

scholarly journals A Multicentre Study of Psychological Variables and the Prevalence of Burnout among Primary Health Care Nurses

2019 ◽  
Vol 16 (18) ◽  
pp. 3242 ◽  
Author(s):  
Elena Ortega-Campos ◽  
Guillermo A. Cañadas-De la Fuente ◽  
Luis Albendín-García ◽  
José L. Gómez-Urquiza ◽  
Carolina Monsalve-Reyes ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Multicentre Study ◽  
Emotional Exhaustion ◽  
Burnout Syndrome ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Psychological Variables ◽  
Primary Health ◽  
Primary Health Care Nurses

Nurses in primary health care (PHC) have multiple responsibilities but must often work with limited resources. The study’s aim was to estimate burnout levels among PHC nurses. A Quantitative, observational, cross-sectional, multicentre study of 338 nurses working in PHC in the Andalusian Public Health Service (Spain) is presented. A total of 40.24% of the nurses studied had high levels of burnout. The dimensions of emotional exhaustion and depersonalisation were significantly associated with anxiety, depression, neuroticism, on-call duty and seniority-profession and inversely related to agreeableness. In addition, depersonalisation was significantly associated with gender, and emotional exhaustion correlated inversely with age. Personal achievement was inversely associated with anxiety and depression and positively correlated with agreeableness, extraversion and responsibility. There is a high prevalence of burnout among nurses in PHC. Those most likely to suffer burnout syndrome are relatively young, suffer from anxiety and depression and present high scores for neuroticism and low ones for agreeableness, responsibility and extraversion.

PREVENTIVE APPROACHES TO DIAGNOSTICS OF ANXIETY-DEPRESSIVE DISORDERS IN PATIENTS OF PRIMARY HEALTH CARE

2013 ◽  
Vol 17 (2) ◽  
pp. 37
Author(s):  
A K Zinkovskii ◽  
E A Moroseeva ◽  
K A Zinkovskii ◽  
B N Kuzmichev ◽  
O M Rodionova
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Depressive Disorders ◽  
Primary Health

Prevalence, symptom patterns and comorbidity of anxiety and depressive disorders in primary care in qatar

2011 ◽  
Vol 26 (S2) ◽  
pp. 138-138
Author(s):  
A. Bener
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Depressive Disorders ◽  
Common Symptom ◽  
Age Group ◽  
Depression And Anxiety ◽  
Primary Health ◽  
Co Morbidity

AimTo determine the prevalence of anxiety and depressive disorders in Qatari population who attend the primary health care settings and examine their symptoms patterns and co-morbidity.DesignA cross sectional.SettingPrimary health care center, QatarSubjectsA total of 2080 Qatari subjects aged 18 to 65 years were approached and 1660 (79.8%) patients participated in this study.MethodsThe study was based on a face to face interview with a designed diagnostic screening questionnaire which consists of 17 questions about symptoms and signs of anxiety and depression disorders. Physicians determined the definitive diagnosis for depression and anxiety disorders by further checking and screening their symptoms.ResultsThe overall prevalence of depression and anxiety disorder was 13.5% and 10.3% respectively. Qatari women were at higher risk for depression (53.1% vs 46.9%) and anxiety disorder (56.7% vs 43.3%) compared to men. More than half of the sufferers with anxiety (56.7%) and depression (53.1%) were Qatari women with a higher frequency in the age group 1834 years. There were significant differences between men and women with depression in terms of age group (p = 0.004), marital status (p = 0.04), occupation (p < 0.001) and household income (p = 0.002). Nervousness was the most common symptom in subjects with anxiety disorders (68.4%), whereas sleep difficulty was the most common symptom in subjects with depressive disorder (59.4%).ConclusionThe depression was more prevalent in Qatari than anxiety disorders. The high risk groups of depression and anxiety disorders were being female, married, middle aged and highly educated.

scholarly journals Epidemiological study of the prevalence of depressive disorders in primary health care in Morocco

2015 ◽  
Vol 06 (04) ◽  
pp. 477-480 ◽  
Author(s):  
Bouchra Oneib ◽  
Maria Sabir ◽  
Naima Abda ◽  
Abderazak Ouanass
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Depressive Disorders ◽  
Univariate Analysis ◽  
Dysthymic Disorder ◽  
Psychiatric Disease ◽  
Childbearing Age ◽  
Primary Health ◽  
Depressive Episodes ◽  
The Impact

ABSTRACT Objective: To determine the prevalence and the impact of depressive disorders in primary health care and its associated factors. Methodology: It's a cross-sectional study with 351 participants selected from Moroccan primary care facilities, aged above 18 years without chronic somatic or psychiatric disease. The participants answered a questionnaire that included demographic characteristics, the Mini International Neuropsychiatric Interview for major depressive episode (MDE), dysthymic disorder and the Global Assessment of Functioning (GAF). Statistical analysis was performed by the SPSS 13.0 software. Results: The prevalence of depressive disorders in the sample was 13.7%, that of MDE was 9.1%, while dysthymic disorder was 4.3%, the rate of recurrent depressive episodes was 38.2% (6% of participants), and the prevalence of depression over a lifetime was 17.7%. The percentage of depression was higher among women than men (P = 0.01). 6.3% of depressed patients have already attempted to suicide. Analysis of GAF scores showed an average of 76.2 ± 24, a lower score was significantly found among patients with current MDE (P = 0.001), dysthymic subjects (P = 0.001) and those who suffer from recurrent MDE (P = 0.001). Depressive disorders in univariate analysis were associated with: Female gender P = 0.01 odds ratio (OR) 2.1 (1.09–4.3), unemployment P = 0.02 OR 0.4 (0.2–0.9), and childbearing age P = 0.004 OR 3.5 (1.5–8). Adjusted OR has not demonstrated a significant association. Conclusion: The high prevalence of depressive disorders, suicide risk, and the alteration of the quality of life among primary health care patients in Morocco suggest the importance of identifying and treating this population.

scholarly journals Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Monica Köhn ◽  
Ulla Persson Lundholm ◽  
Ing-Liss Bryngelsson ◽  
Agneta Anderzén-Carlsson ◽  
Elisabeth Westerdahl
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Status ◽  
Standard Care ◽  
Anxiety And Depression ◽  
Randomized Controlled ◽  
Primary Health ◽  
Yoga Group ◽  
Insomnia Severity ◽  
Overall Health Status

An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of53±12years were included. General stress level (measured using Perceived Stress Scale (PSS)), burnout (Shirom-Melamed Burnout Questionnaire (SMBQ)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), insomnia severity (Insomnia Severity Index (ISI)), pain (visual analogue scale (VAS)), and overall health status (Euro Quality of Life VAS (EQ-VAS)) were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P<0.000), anxiety (P<0.019), and overall health status (P<0.018) compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

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