2008
DOI: 10.1016/j.eurpsy.2008.06.006
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Abstract: Primary care differs considerably from specialist mental health settings: problems are presented in undifferentiated forms, with consequent difficulties in distinguishing between distress and disorder, and a complex relationship between psychological, mental and social problems and their temporal variations. Existing psychiatric diagnostic systems, including ICD-10-PHC and DSM-IV-PC, are often difficult to apply in primary care. They do not adequately address co-morbidity, the substantial prevalence of sub-thr… Show more

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Cited by 62 publications
(64 citation statements)
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References 63 publications
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“…The instrument allows for simple linkage between reason for encounter, diagnosis and intervention and for ordering of clinical data in an episode of care structure. 28 Since its introduction in 1987, the ICPC has been translated in more than 20 languages. 29 In several studies, the ICPC-2 has been found to be adequate, reliable, and feasible for use in primary health care settings.…”
Section: Methodsmentioning
confidence: 99%
“…The instrument allows for simple linkage between reason for encounter, diagnosis and intervention and for ordering of clinical data in an episode of care structure. 28 Since its introduction in 1987, the ICPC has been translated in more than 20 languages. 29 In several studies, the ICPC-2 has been found to be adequate, reliable, and feasible for use in primary health care settings.…”
Section: Methodsmentioning
confidence: 99%
“…The MUS spectrum ranges from mild or moderate to severe and very severe MUS [2,8,9]. A core problem of the current somatoform categories in the ICD-10 and DSM-IV is that mild and moderate MUS are poorly covered [2,10,11]. In one study, the full or abridged DSM-IV somatoform diagnoses were found in only 23.3% of 206 distressed, high-utilizing primary care patients with MUS [3].…”
Section: Introductionmentioning
confidence: 94%
“…As with other conditions where diagnosis is made on the basis of inevitably arbitrary cut-off points on scoring systems (such as anaemia, asthma, and diabetes), we also need to consider the context of symptoms, and understand the complexity of the relationship between psychological, physical, and social problems and their temporal variations. 7 The updated NICE guidelines on depression note that identification of major depression should be based not only on its severity but also on persistence, the presence of other symptoms, and the degree of functional and social impairment. 8 Many people with sub-threshold disorders in current classification systems experience significant degrees of disability, while people with severe depressive symptoms may be able to function with a remarkable degree of normality.…”
Section: Reflections On Gps' Responses To Depressionmentioning
confidence: 99%