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The ability of general practitioners to detect mental disorders in primary health care.

https://arctichealth.org/en/permalink/ahliterature216423
Source
Acta Psychiatr Scand. 1995 Jan;91(1):52-6
Publication Type
Article
Date
Jan-1995
Author
M. Joukamaa
V. Lehtinen
H. Karlsson
Author Affiliation
Department of Psychiatry, University of Turku, Finland.
Source
Acta Psychiatr Scand. 1995 Jan;91(1):52-6
Date
Jan-1995
Language
English
Publication Type
Article
Keywords
Adult
Clinical Competence
Curriculum
Education, Medical, Graduate
Family Practice - education
Female
Finland
Humans
Male
Mental Disorders - diagnosis - psychology - therapy
Patient care team
Primary Health Care
Psychiatry - education
Psychophysiologic Disorders - diagnosis - psychology - therapy
Sampling Studies
Somatoform Disorders - diagnosis - psychology - therapy
Abstract
The ability to detect mental disorders varies greatly among general practitioners in primary health care. The aim of this study was to determine the factors underlying the differences between general practitioners in the ability to recognize mental disorders in Finnish patient populations. The group studied consisted of 1000 randomly selected adult patients of primary care facilities in the city of Turku. The Symptom Checklist (SCL-25) was used as the reference method in the identification of psychiatric cases. According to the SCL-25, one fourth of the sample had mental disorders. A good recognition ability was associated with postgraduate psychiatric training and qualification as a specialist in general practice. Surprisingly, Balint group training, which is a method intended to improve the ability of general practitioners to manage their patients' mental health problems, was associated rather with poor than good detection ability.
Notes
Comment In: Acta Psychiatr Scand. 1995 Oct;92(4):3198848961
PubMed ID
7754788 View in PubMed
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[A cognitive approach to overutilization of health services].

https://arctichealth.org/en/permalink/ahliterature192488
Source
Lakartidningen. 2001 Oct 24;98(43):4745-6
Publication Type
Article
Date
Oct-24-2001

Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up.

https://arctichealth.org/en/permalink/ahliterature117684
Source
J Psychosom Res. 2013 Jan;74(1):31-40
Publication Type
Article
Date
Jan-2013
Author
Lone Overby Fjorback
Mikkel Arendt
Eva Ornbøl
Harald Walach
Emma Rehfeld
Andreas Schröder
Per Fink
Author Affiliation
The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark. lonefjor@rm.dk
Source
J Psychosom Res. 2013 Jan;74(1):31-40
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
Adult
Anxiety Disorders - diagnosis - psychology - therapy
Awareness
Cognitive Therapy - methods
Comorbidity
Denmark
Depressive Disorder - diagnosis - psychology - therapy
Feasibility Studies
Female
Follow-Up Studies
Health Status Indicators
Humans
Illness Behavior
Male
Meditation - methods - psychology
Middle Aged
Psychotherapy, Brief - methods
Quality of Life - psychology
Relaxation Therapy - methods - psychology
Somatoform Disorders - diagnosis - psychology - therapy
Syndrome
Treatment Outcome
Abstract
To conduct a feasibility and efficacy trial of mindfulness therapy in somatization disorder and functional somatic syndromes such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, defined as bodily distress syndrome (BDS).
We randomized 119 patients to either mindfulness therapy (mindfulness-based stress reduction and some cognitive behavioral therapy elements for BDS) or to enhanced treatment as usual (2-hour specialist medical care and brief cognitive behavioral therapy for BDS). The primary outcome measure was change in physical health (SF-36 Physical Component Summary) from baseline to 15-month follow-up.
The study is negative as we could not demonstrate a different development over time for the two groups (F(3,2674)=1.51, P=.21). However, in the mindfulness therapy group, improvement was obtained toward the end of treatment and it remained present at the 15-month follow-up, whereas the enhanced treatment as usual group achieved no significant change until 15-month follow-up. The change scores averaged half a standard deviation which amounts to a clinically significant change, 29% changed more than 1 standard deviation. Significant between-group differences were observed at treatment cessation.
Mindfulness therapy is a feasible and acceptable treatment. The study showed that mindfulness therapy was comparable to enhanced treatment as usual in improving quality of life and symptoms. Nevertheless, considering the more rapid improvement following mindfulness, mindfulness therapy may be a potentially useful intervention in BDS patients. Clinically important changes that seem to be comparable to a CBT treatment approach were obtained. Further research is needed to replicate or even expand these findings.
PubMed ID
23272986 View in PubMed
Less detail

The uncertain consultation and patient satisfaction: the impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills.

https://arctichealth.org/en/permalink/ahliterature70486
Source
Psychosom Med. 2005 Nov-Dec;67(6):897-905
Publication Type
Article
Author
Lisbeth Frostholm
Per Fink
Eva Oernboel
Kaj S Christensen
Tomas Toft
Frede Olesen
John Weinman
Author Affiliation
Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus N, Denmark.
Source
Psychosom Med. 2005 Nov-Dec;67(6):897-905
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Attitude to Health
Communication
Comparative Study
Family Practice - education - methods - standards
Female
Follow-Up Studies
Health Services Research
Health status
Humans
Male
Middle Aged
Multivariate Analysis
Patient satisfaction
Personality Inventory
Physicians - psychology - standards
Prognosis
Psychiatric Status Rating Scales
Questionnaires
Referral and Consultation - standards
Regression Analysis
Research Support, Non-U.S. Gov't
Somatoform Disorders - diagnosis - psychology - therapy
Teaching
Abstract
OBJECTIVE: To identify predictors of patient satisfaction among a range of patient and practitioner variables. In particular, to focus on patients' illness perceptions and the impact of a randomized controlled trial on the training of physicians in general communication skills and how to treat patients presenting with poorly defined illness. METHODS: A randomized controlled follow-up study conducted in 28 general practices in Aarhus County, Denmark. Half of the physicians were randomized into an educational program on treatment of patients presenting with medically unexplained symptoms (somatization). One thousand seven hundred eighty-five general practice attenders presenting a new health problem completed questionnaires on illness perceptions, physical functioning, and mental distress before the consultation. After the consultation, a questionnaire including relational and communicative domains of patient satisfaction with the current consultation was completed. The physicians completed a questionnaire for each patient on diagnostics and prognostics. Predictors of patient satisfaction were determined by logistic regression. RESULTS: A large number of patient and practitioner variables predicted satisfaction in univariate logistic regression models. Results from a multivariate logistic model showed that the illness perceptions "uncertainty" (patient not knowing what is wrong) and "emotional representations" (the complaint making the patient feel worried, depressed, helpless, afraid, hopeless) predicted dissatisfaction at OR (CI) = 1.8 (1.3-2.4), p
PubMed ID
16314594 View in PubMed
Less detail