Psychiatrists' and Internists' Knowledge and Attitudes About Delivery of Clinical Preventive Medical Services

Carney, Caroline P.; Yates, William R.; Goerdt, Christopher J.; Doebbeling, Bradley N.

doi:10.1176/ps.49.12.1594

Cited by 29 publications

(11 citation statements)

References 27 publications

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“…In contrast, CCM-based models have been shown to be cost-neutral [46]. Although other approaches to improving medical care for patients with mental disorders exist, such as the training of psychiatrists in general medical care [49,50], psychiatrists lack the time, resources, and incentives to treat their patients' medical conditions (Table 3). Alternatively, a CCM-based model in which a physician extender (registered nurse) provides care management across existing providers is desirable and likely to be cost-efficient and sustainable in routine care.…”

Section: Improving Medical Care For Patients With Bipolar Disordermentioning

confidence: 99%

The burden of general medical conditions in patients with bipolar disorder

Kilbourne

2005

Curr Psychiatry Rep

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We reviewed the current literature on medical comorbidity burden in bipolar disorder. Overall, current studies suggest that numerous medical conditions may occur disproportionately within bipolar disorder patient populations, including hypertension, hyperlipidemia, and hepatitis C infection. In addition, the determinants of increased burden of medical comorbidity in patients with bipolar disorder include metabolic-related factors, health care access barriers, and patient behavioral and treatment factors. Overall, interventions specifically designed to reduce the burden of medical comorbidity in bipolar disorder are needed, especially those that emphasize changes at the health system level to facilitate coordination of medical and psychiatric care.

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Section: Improving Medical Care For Patients With Bipolar Disordermentioning

confidence: 99%

The burden of general medical conditions in patients with bipolar disorder

Kilbourne

2005

Curr Psychiatry Rep

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“…In a somewhat similar vein, Carney et al [14] gave a questionnaire to a group of residents and faculty in both psychiatry and internal medicine, examining their knowledge and attitudes toward clinical preventive services. Both groups reported similar attitudes toward and beliefs in the efficacy of preventive medical services.…”

Section: Health Care Practices and Utilizationmentioning

confidence: 99%

Comorbid medical illness in psychiatric patients

Goldman

2000

Curr Psychiatry Rep

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Patients with psychiatric illnesses may be at higher risk for the development of certain medical problems. Those with more severe psychiatric illnesses may encounter barriers to promoting good health and to obtaining good health care when comorbid illnesses do occur. This paper reviews some of the recent literature on health care practices and health system access for the mentally ill; HIV care and its relationship to mental disorders; drug interactions between general medical drugs and psychotropics; and certain medical conditions that appear to co-occur more frequently with psychiatric disorders.

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“…Including more medical content in mental health curricula may require interdisciplinary collaborations in professional development. Psychiatrists score well on baseline knowledge of preventive medical services and are interested in providing such services, despite a relative lack of training (40).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Physical Illness by Mental Health Clinicians During Intake Visits

Carson

Katz²,

Gao³

et al. 2010

Psychiatric Services

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Objectives-This study explored how mental health clinicians assess and respond to physical illness among patients presenting for mental health intake evaluations.Methods-A total of 129 adults were seen for a mental health intake visit. The intake visits were videotaped and involved 47 mental health clinicians from eight clinics who provided outpatient mental health and substance abuse treatment. A total of 120 videos of patient-provider interactions were coded using an information checklist containing 21 physical illness items. Twenty-eight intake visits exemplifying in-depth physical illness assessments were selected and transcribed for qualitative analysis.Results-Physical health was discussed in most intake visits (87%). Clinicians elicited information on physical health in 79 visits (66%), while patients volunteered such information in 80 visits (67%). Frequency of assessment differed by clinician discipline (p<.05) and by patient ethnicity (p=.06). Qualitative analysis revealed characteristics of appropriate assessments, such as formulating whether physical conditions were responsible for psychiatric symptoms in the differential diagnosis, noting physical side effects of medications, adjusting treatment plans, encouraging patient contact with primary care providers, and promoting physical health care.Conclusions-Assessment of physical illness is relatively common for mental health clinicians but was lacking in one-third of the cases in this study, until raised by patients. Because frequency of assessment differed by clinician discipline and patient ethnicity, innovations in patient assessment and clinician education are needed to address disparities in management of physical illness among individuals with mental illness.There are important reasons for mental health clinicians to be interested in the physical health of their patients. Physical illness occurs among more than 45% of psychiatric outpatients and often goes undiscovered (1-6), leading to lower quality of life, decreased functioning, and increased risk of early death (7,8). Individuals with severe mental illness die earlier than the general population because of poor health behaviors, medication side effects, inadequate preventive care, and insufficient medical care (9-12).Primary care interventions that address the physical health of persons with mental illness include care coordinators, specialized primary care clinics, and medical teams within psychiatric settings (11). An expanded medical role for mental health clinicians has been suggested but is less studied (13).The authors report no competing interests. Persons from ethnic minority groups with comorbid physical and mental illness face even greater disparities in medical care, including low rates of treatment for chronic pain, asthma, hepatitis, and diabetes (14,15). However, most health disparities research examines physician behavior in nonpsychiatric settings. In mental health settings that serve as safety-net treatment facilities, social workers, psychologists, and nurses provid...

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Psychiatrists' and Internists' Knowledge and Attitudes About Delivery of Clinical Preventive Medical Services

Cited by 29 publications

References 27 publications

The burden of general medical conditions in patients with bipolar disorder

The burden of general medical conditions in patients with bipolar disorder

Comorbid medical illness in psychiatric patients

Assessment of Physical Illness by Mental Health Clinicians During Intake Visits

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