Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-22T07:04:29.807Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental health in primary care

An epidemiological study of morbidity and use of health resources

Published online by Cambridge University Press:  03 January 2018

José Luis Vázquez-Barquero ,
José Garcia ,
Jesús Artal Simón ,
Celso Iglesias ,
Javier Montejo ,
AndréS Herrán  and
Graham Dunn
José Luis Vázquez-Barquero*
Affiliation:
Clinical and Social Psychiatry Research Unit, University Hospital “Marqués de Valdecilla”, University of Cantabria, Santander, Spain
José Garcia
Affiliation:
Mental Health Services, Autonomous Community of the “Principado de Asturias”, Oviedo, Spain
Jesús Artal Simón
Affiliation:
Clinical and Social Psychiatry Research Unit, University Hospital “Marqués de Valdecilla”, University of Cantabria, Santander, Spain
Celso Iglesias
Affiliation:
Mental Health Services, Autonomous Community of the “Principado de Asturias”, Oviedo, Spain
Javier Montejo
Affiliation:
Mental Health Services, Autonomous Community of the “Principado de Asturias”, Oviedo, Spain
AndréS Herrán
Affiliation:
Clinical and Social Psychiatry Research Unit, University Hospital “Marqués de Valdecilla”, University of Cantabria, Santander, Spain
Graham Dunn
Affiliation:
Institute of Psychiatry, London
*
Professor J.L. Vázquez-Barquero, Unidad de Investigación en Psiquiatría Clínicay Social. Hospital Universitario “Marqués de Valdecilla”. Av. Valdecilla s/n. Santander 39008, Spain
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The main objectives of the survey were: (a) to analyse the sociological, clinical and illness-related correlates of mental illness in primary care; (b) to study, during one-year follow-up, outcome and use of health resources.

Method

The survey comprised a two-phase cross-sectional study. In the first phase patients were classified using the GHQ-28 or by the general practitioner (GP). In the second phase they were assessed by the SCAN system.

Results

The prevalence rate of mental illness (in attenders) using the GHQ was 33.2%. The corresponding rate for the GP was 14.1%, and for the SCAN 31.5%. Mental illness mainly comprised depression, anxiety and alcohol-related diagnoses. The presence of mental illness and the use of health resources during follow-up were dependent on demographic characteristics and on their original psychiatric status.

Conclusions

In primary care, mental illness constitutes a major health problem. Despite this fact. GPs do not recognise a substantial proportion of these health problems.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 6 , June 1997 , pp. 529 - 535
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn.) (DSM-IV). Washington, DC: APA.Google Scholar
Barrot, J. E., Barrot, J. A., Oxman, T. E., et al (1988) The prevalence of psychiatric disorders in primary care practice. Archives of General Psychiatry 45, 1100–1106.Google Scholar
Bellantuono, C., Florio, R., Williams, P., et al (1987) Psychiatric morbidity in an Italian general practice. Psychological Medicine, 17, 243–247.CrossRefGoogle Scholar
Belloc, N. B., Breslow, L. & Hochstim, J. R. (1971) Measurement of physical health in a general population survey. American Journal of Epidemiology, 93, 328–336.CrossRefGoogle Scholar
Coyne, J. C., Schwenk, T. L. & Fechner-Bates, S. (1995) Nondetection of depression by primary care physicians reconsidered. General Hospital Psychiatry, 17, 3–12.Google Scholar
Fink, P., Bortquist, L., Brevik, J. I., et al (1995) Psychiatric morbidity in a primary public health care: a Nordic multicentre investigation. Part I. Method and prevalence of psychiatric morbidity. Acta Psychiatrica Scandinavia, 92, 409–418.CrossRefGoogle Scholar
Fitzmaurice, G. M., Laird, N. M., Zahner, G. E. P., et al(1995) Bivariate logistic regression analysis of childhood pathology. Ratings using multiple informants. American Journol of Epidemiology, 142, 1194–1203.Google Scholar
Goldberg, D. (1995) Epidemiology of mental disorder in primary care settings. Epidemiologic Reviews, 17, 182–190.CrossRefGoogle ScholarPubMed
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community. The Path Way to Psychiatric Care. London: Tavistock.Google Scholar
Goldberg, D. & Huxley, P. & Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER-Nelson Google Scholar
Goldberg, D. & Huxley, P. & Williams, P. & Lecrubier, Y. (1995) Form and frequency of mental disorders across centres. In Mental Illness in General Health Care. An International Study (eds Onstün, T. B. & Sartorius, N.). pp. 323–334. Chichester: John Wiley Google Scholar
Herding, T. W., Arengo, M. W., Baltazar, J., et al (1980) Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries. Psychological Medicine, 10, 231–241.Google Scholar
Higgins, E. S. (1994) A review of unrecognised mental illness in primary care. Archives of Family Medicine, 3, 908–917.Google Scholar
Kessler, L. G., Clearly, P. D. A Burke, J. D. (1985) Psychiatric disorders in primary care. Archives of General Psychiatry, 42, 583–587.Google Scholar
Lloyd, K & Jenkins, R. (1995) The economics of depression in primary care. Department of Health initiatives. British Journal of Psychiatry, 166, (suppl. 27). 60–62.CrossRefGoogle Scholar
Lobo, A, Pérez-Echeverrfa, H. J. & Artel, J. (1986) Validity of the Scaled Version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychological Medicine, 16, 135–140.Google Scholar
Mann, A. H., Jenkins, R. & Belsey, E. (1981) The twelve-month outcome on patients with neurotic illness in general practice. Psychological Medicine, 11, 535–550.Google Scholar
Ormel, J., van den Brink, W., Koeter, M. V. J., et al (1990) Recognition, management and outcome of psychological disorders in primary care: a naturalistic follow-up study. Psychological Medicine, 20, 909–923.CrossRefGoogle ScholarPubMed
Ormel, J., van den Brink, W., Koeter, M. V. J., Koeter, M. V. J., van den Brink, W., et al (1991) Recognition, management and course of anxiety and depression in general practice. Archives of General Psychiatry, 48, 700–706.CrossRefGoogle ScholarPubMed
Ormel, J., van den Brink, W., Koeter, M. V. J., Koeter, M. V. J., van den Brink, W., & Costa e Silva, J. A. (1995) The impact of psychopathology on disability and health perceptions. In Mental Illness in General Health Care. An International Study (eds Ünstün, T. B. & Sartorius, N.). pp. 335–346. Chichester: John Wiley Google Scholar
Pickles, A., Dunn, G. & Vázquez-Barquero, J. L. (1995) Screening for stratification in two-phase (“two-stage”) epidemiological surveys. Statistics in Medicine, 4, 73–89.Google ScholarPubMed
Robins, L N., Wing, J. K., Wittchen, H. U., et al (1988) The Composite International Diagnostic Interview: an epidemiological instrument. Archives of General Psychiatry, 45, 1069–1077.Google Scholar
Seivewright, H., Tyrer, P., Casey;, P., et el (1991) A three-year follow-up of psychiatric morbidity in urban and rural primary care. Psychological Medicine, 21, 495–503.Google Scholar
Shah, B. V., Folsom, R. E., La Vange, L. M., et al (1993) Statistical Methods and Mathemavcal Algorithms used in SUDAA North Carolina: Research Triangle Institute.Google Scholar
Simon, G. E., Von Korff, M. & Barlow, W. (1995) Health care costs of primary care patients with recognized depression. Archives of General Psychiatry, 52, 850–856.Google Scholar
Spss (1993) SPSS Windows 6.0. Chicago: SPSS Inc.Google Scholar
Tiemens, B. G., Ormel, J. & Simon, G. E. (1996) Occurrence, recognition, and outcome of psychological disorders in primary care. American Journal of Psychiatry, 153, 634–644.Google Scholar
ÜnstOn, T. B. & Sartorius, N. (eds) (1995) Mental Illness in General Health Care. An International Study Chichester: John Wiley.Google Scholar
Vázquez-Barquero, J. L. (1990) Mental health in primary care settings. In The Public Health Impact of Mental Disorders (eds D. Goldberg & D. Tantam), pp. 35–44. Toronto: Hogrefe & Huber Google Scholar
Vázquez-Barquero, J. L., Wilkinson, G., Williams, P., et al (1990) Mental health and medical consultation in primary care settings. Psychological Medicine, 20, 681–694.Google Scholar
Vázquez-Barquero, J. L., Wilkinson, G., Williams, P., Diez-Manrique, J. F., Gelte, L., et el (1992) Why people with probable minor psychiatric morbidity consult a doctor. Psychological Medicine, 22, 495–502.Google Scholar
Vázquez-Barquero, J. L., Wilkinson, G., Williams, P., Diez-Manrique, J. F., Gelte, L., Galte, L, Artal, S., et al (1994) Desarrollo y verificación de la versión Española de la entrevista psiquiátrica “Sistema SCAN” (Cuestionarios para la Evaluación Clínica en Neuropsiquiatría). Actas Luso-Españolas de Neurología y Psiquiatría, 22, 109–120.Google Scholar
Vázquez-Barquero, J. L., Wilkinson, G., Williams, P., Diez-Manrique, J. F., Gelte, L., Galte, L, Artal, S., Garda, J., Montalo, A., et al (1995) Aplicabilidad de la versión Española delo Cuestionario de Salud Física (PSI) de Belloc: una escala de medida del estado de saJud percibida. Actas-Luso Españolas de Neurología y Psiquiatría, 23, 114–123.Google Scholar
Wing, J. K., Cooper, J. E., & Sartorius, N. (1974) The Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. Babor, T., Brugha, T., et al (1990) SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry, 47, 589–593 CrossRefGoogle ScholarPubMed
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.