Common mental disorders among patients in primary health care in Greenland

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

International Journal of Mental Health Systems ◽

10.1186/s13033-021-00488-6 ◽

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.

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

Psicologia: Reflexão e Crítica ◽

10.1186/s41155-018-0101-4 ◽

2018 ◽

Vol 31 (1) ◽

Cited By ~ 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

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

Harvard Review of Psychiatry ◽

10.1080/10673220303954 ◽

2003 ◽

Vol 11 (3) ◽

pp. 166-173 ◽

Cited By ~ 20

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

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

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-014-0962-5 ◽

2014 ◽

Vol 50 (3) ◽

pp. 429-443 ◽

Cited By ~ 10

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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02 - DRUG-DRUG INTERACTIONS IN COMMON MENTAL DISORDERS PATIENTS ATTENDED IN PRIMARY HEALTH CARE

10.26226/morressier.5d1a038957558b317a1401be ◽

2019 ◽

Author(s):

Tatiana Borges ◽

Adriana Inocenti Miasso

Keyword(s):

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

Drug Interactions ◽

Common Mental Disorders ◽

Primary Health

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The primary health care version of ICD-11: the detection of common mental disorders in general medical settings

General Hospital Psychiatry ◽

10.1016/j.genhosppsych.2012.06.006 ◽

2012 ◽

Vol 34 (6) ◽

pp. 665-670 ◽

Cited By ~ 26

Author(s):

David P. Goldberg ◽

James J. Prisciandaro ◽

Paul Williams

Keyword(s):

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

Common Mental Disorders ◽

Medical Settings ◽

Primary Health

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Common mental disorders among those attending primary health clinics and traditional healers in urban Tanzania

The British Journal of Psychiatry ◽

10.1192/bjp.183.4.349 ◽

2003 ◽

Vol 183 (4) ◽

pp. 349-355 ◽

Cited By ~ 96

Author(s):

Mdimu Charua Ngoma ◽

Martin Prince ◽

Anthony Mann

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Mental Disorders ◽

Mental Disorder ◽

Health Care Services ◽

Common Mental Disorders ◽

Common Mental Disorder ◽

Traditional Healers ◽

Primary Health

BackgroundTraditional healers provide a popular and accessible service across the African continent. Little is known of the characteristics or mental health status of those using these services.AimsTo determine and compare the prevalence of common mental disorder among, and the characteristics of, those attending primary health care clinics (PHCs) and traditional healer centres (THCs) in Dar-es-Salaam.MethodThe Clinical Interview Schedule – Revised was used to determine the prevalence of mental disorders in 178 patients from PHCs and 176 from THCs, aged 16–65 years.ResultsThe prevalence of common mental disorders among THC patients (48%) was double that of PHC patients (24%). Being older, Christian, better educated, and divorced, separated or widowed were independently associated with THC attendance. None of these factors explained the excess of mental disorder among THC attenders.ConclusionsThe high prevalence of mental disorders among THC attenders may reflect the failure of primary health care services adequately to detect and treat these common and disabling disorders. Traditional healers should be involved in planning comprehensive mental health care.

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Training primary health care workers in mental health and its impact on diagnoses of common mental disorders in primary care of a developing country, Malawi: a cluster-randomized controlled trial

Psychological Medicine ◽

10.1017/s0033291713001141 ◽

2013 ◽

Vol 44 (3) ◽

pp. 657-666 ◽

Cited By ~ 42

Author(s):

F. Kauye ◽

R. Jenkins ◽

A. Rahman

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Developing Countries ◽

Primary Health Care ◽

Mental Disorders ◽

Intervention Study ◽

Common Mental Disorders ◽

Prevalence Rates ◽

Primary Health

BackgroundMental health problems are common in primary care, with prevalence rates of up to 40% reported in developing countries. The study aim was to evaluate the impact of a specially designed toolkit used to train primary health care (PHC) workers in mental health on the rates of diagnosed cases of common mental disorders, malaria and non-specific musculoskeletal pains in primary care in Malawi.MethodClinics with out-patient services in the designated district were randomly divided into control and intervention arms. Using a two-phase sampling process, Self-Reporting Questionnaire scores, data on diagnoses made by PHC workers and results of the Structured Clinical Interview for DSM-IV for depression were collected from 837 consecutively attending adult patients in the pre-intervention study and 2600 patients in the post-intervention study.ResultsThe point prevalence rates for probable common mental disorder and depression were 28.8% and 19%, respectively. Rates for both anxiety and depression diagnoses by PHC workers at baseline were 0% in both arms. Following training, there were significant differences between the two arms in the rates of diagnosed cases of depression [9.2% v. 0.5%, odds ratio (OR) 32.1, 95% confidence interval (CI) 7.4–144.3, p ⩽ 0.001], anxiety (1.2% v. 0%, p ⩽ 0.001) and malaria (31% v. 40%, OR 0.62, 95% CI 0.43–0.89, p = 0.01). The intervention arm had more cases diagnosed with depression and anxiety while the control arm had more cases diagnosed with malaria.ConclusionsTraining of PHC workers in mental health with an appropriate toolkit will contribute significantly to the quality of detection and management of patients seen in primary care in developing countries.

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