Mental disorders in primary care

Abstract

Current estimates indicate that 50% of the population experience at least one mental disorder in their lifetime and that at least 25% have suffered a mental disorder in the past year. recognition, diagnosis, treatment, and referral depend overwhelmingly on general practitioners, at least one third of whose consultations have a direct and explicit psychological component. Yet despite this intensive familiarization with the presentation of mental pathology, and the appropriateness of the primary care setting to its management, even the most recent surveys indicate that performance is best described by the rule of diminishing halves: only half the patients with a thresh-old disorder are recognized; only half of those recognized are treated; and only half of those treated are effectively treated. There is no single solution to this problem, only multiple solutions, which must be aimed, consistently and simultaneously, at the patient, practitioner, practice, and research levels.

Pediatricians’ and health visitors’ views towards detection and management of maternal depression in the context of a weak primary health care system: a qualitative study

“…There is evidence that mental health services are more acceptable when they are decentralized and integrated into primary healthcare [ 19 , 20 ]. Moreover, research findings from previous studies indicated that Greeks display less favorable attitudes towards mental illness compared to people from other countries [ 26 ].…”

“…Both the high prevalence of mental disorders in the community and the reform of mental health services (e.g. reduction of psychiatric hospital beds) have resulted in a larger burden of people facing mental health problems in primary care settings [ 19 ]. Despite this however, the detection and management of mental disorders in primary care is still understudied.…”

“…Research suggests that the quality and effectiveness of a primary health care system affects the recognition and management of mental disorders [ 19 - 21 ].…”

“…To our knowledge this is the first study conducted in a high income European country with a weak primary care system that investigates the primary care providers’ views on the detection and management of maternal depression. This is important, due to the negative impact of the weak primary health care system on the recognition and management of mental health problems and maternal depression [ 19 , 20 , 37 ]. Such an impact poses an additional risk for both mother and child.…”

General Practitioners are poor at identifying the eating disorders

“…However, some authors have underlined that improving recognition of all mental health disorders in primary care might not be possible and that in fact identification rates of mental health disorders are not very different from those of physical disorders ( Wittchen, Mühlig, & Beesdo, 2003 ). They also argue that failed recognition might not only be due to GP's poor knowledge, but to a natural threshold in illness severity, whereby GPs will identify disorders that are above that threshold.…”