Abstract：
OBJECTIVES:To assess professionals' adherence to evidence-based guidelines and to investigate whether or not this is influenced by recording of the diagnosis and symptom severity. METHOD:Analysis of baseline cross-sectional data of a cohort study of 721 primary care patients with a confirmed diagnosis of a depressive or anxiety disorder. Information on the management of depressive and anxiety disorders was gathered from the electronic medical patient records. Guideline adherence was measured by an algorithm, based on performance indicators. RESULTS:Forty-two percent of the patients with a depressive disorder was treated in accordance with the guideline, whereas 27% of the patients with an anxiety disorder received guideline-consistent care. The provision of care in line with current depression and anxiety guidelines was around 50% for persons with both types of disorders. Documentation of an International Classification of Primary Care diagnosis of depression or anxiety disorder appeared to have a strong influence on guideline adherence. Symptom severity, however, did not influence guideline adherence. CONCLUSIONS:Adherence to depression and anxiety guidelines can be improved, even when the general practitioner makes the diagnosis and records it. Data on actual health care delivery and quality of care provide insight and may be useful in developing quality improvement activities.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Smolders M,Laurant M,Verhaak P,Prins M,van Marwijk H,Penninx B,Wensing M,Grol Rdoi
10.1016/j.genhosppsych.2009.05.011subject
Has Abstractpub_date
2009-09-01 00:00:00pages
460-9issue
5eissn
0163-8343issn
1873-7714pii
S0163-8343(09)00098-Xjournal_volume
31pub_type
杂志文章abstract：:The pattern of inpatient referral to a general hospital psychiatry department was examined in the present study. The referral rate of 3.6% was higher than those reported by other investigators from India. The majority of the patients had concurrent physical illness. Neurotic depression and alcohol dependence were the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(87)90072-7
更新日期：1987-09-01 00:00:00
abstract：OBJECTIVE:This study investigated pediatrician-reported practices in identifying, assessing, and treating traumatic exposure and posttraumatic stress disorder (PTSD) in children. METHOD:Focus groups guided the development of a survey that was mailed to primary care pediatricians in Massachusetts in 2005. Descriptive s...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.07.008
更新日期：2008-11-01 00:00:00
abstract：OBJECTIVE:Primary care providers are increasingly taking on the role of ad hoc mental health provider. However, before patients in primary care can be treated, they must be identified. This study set out to validate a very brief screening instrument for identifying primary care patients with anxiety and depression. ME...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2005.08.010
更新日期：2006-03-01 00:00:00
abstract：:Nonmedical psychotherapists are able to present themselves to the public as psychiatrist-equivalents, except for prescribing drugs, because psychiatrists have neglected to emphasize the nature of medical responsibility, here called "medical primacy." Psychiatric identification with the psychoanalytic and public relati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(79)90029-x
更新日期：1979-09-01 00:00:00
abstract：OBJECTIVE:Post-intensive care syndrome (PICS), which encompasses profound psychological morbidity, affects many survivors of critical illness. We hypothesize that acute psychological stress during the intensive care unit (ICU) confinement likely contributes to PICS. In order to develop strategies that mitigate PICS ass...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2017.04.009
更新日期：2017-07-01 00:00:00
abstract：:The microcomputer allows for the design of a system that functions integrally with both the day-to-day and long-term needs of a consultation-liaison psychiatric service. This article describes a microcomputer system and data structure that can accomplish many of the same research tasks as a minicomputer system. In add...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90022-2
更新日期：1985-04-01 00:00:00
abstract：:The authors explore the difficulties present in the capacity evaluation of patients with strong religious beliefs. The article reviews the legal protection for treatment refusal on religious grounds as well as psychiatry's approach to religion. Clinical cases encountered in an urban hospital are presented to highlight...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(96)00003-5
更新日期：1996-05-01 00:00:00
abstract：:Evaluation of the incidence of depression among cancer patients has been the object of a number of studies. Recent reports of medically ill patients have indicated that depression is related to several dimensions of abnormal illness behavior (e.g., hypochondriasis, irritability, denial, disease conviction). To investi...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(89)90135-7
更新日期：1989-11-01 00:00:00
abstract：OBJECTIVE:Patients with factitious disorder (FD) fabricate illness, injury or impairment for psychological reasons and, as a result, misapply medical resources. The demographic and clinical profile of these patients has yet to be described in a sufficiently large sample, which has prevented clinicians from adopting an ...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2016.05.002
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:This naturalistic prospective study explored the predictors of laboratory test ordering in a psychiatric emergency department. METHODS:We used a standardized questionnaire to collect clinical and nonclinical features in 527 consecutive patients. RESULTS:Test ordering was independently predicted by age, spok...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.02.005
更新日期：2008-07-01 00:00:00
abstract：:Whether psychiatrists can provide effective training of medical students in the psychosocial aspects of patient care should be questioned seriously in view of numerous reports showing that psychiatric education of student physicians had often been inadequate and unpopular. Consequently, objective evidence of psychiatr...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(79)90053-7
更新日期：1979-07-01 00:00:00
abstract：:We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illne...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(90)90050-m
更新日期：1990-09-01 00:00:00
abstract：OBJECTIVE:To characterize temporal trends and outcomes of invasive mechanical ventilation (MV) for people with severe mental disorders (SMD) admitted due to natural causes. METHODS:We identified all 224,507 hospitalizations of patients aged 15-69 who underwent MV in Spain between 2000 and 2015, excluding poisonings an...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2020.04.007
更新日期：2020-01-01 00:00:00
abstract：:The psychiatric consultant is dependent upon the consultee for the implementation of many of his or her recommendations. Therefore, research as to the fate of recommendations suggested to the consultee is of eminent importance. The concordance (performing a suggested recommendation) paradigm, as developed by Popkin et...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(90)90059-l
更新日期：1990-07-01 00:00:00
abstract：OBJECTIVE:The objective was to examine the feasibility, acceptability and preliminary effectiveness of a brief version of Interpersonal Psychotherapy for Depressed Adolescents (BIPT-A) in low-income Latino adolescents treated in an urban pediatric primary care setting. METHOD:Ten adolescents, ages 12 to 19 years, who ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.04.013
更新日期：2015-09-01 00:00:00
abstract：:Issues of suicidal ideation, life-threatening behavior, and vulnerability in cancer patients are addressed. A review of pertinent literature is presented, including the areas of: suicide as a taboo topic; incidence of suicide in cancer patients; identifying patients' suicide potential; and suicide as coping behavior. ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(79)90055-0
更新日期：1979-07-01 00:00:00
abstract：:A liaison rounds is presented, one attended by all members of a consultation-liaison (C-L) team along with the medical director of a burn unit. This structure is designated as a "reverse liaison rounds," as it is the opposite of the conventional liaison meeting, which consists of one C-L consultant and the total nonps...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90087-4
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentially traumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic posttraumatic stress dis...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2013.06.006
更新日期：2013-11-01 00:00:00
abstract：:Individuals with severe mental illness (SMI) are at risk for inadequate general medical and preventive care, but little is known about their visits for primary care. We performed a cross-sectional analysis of primary care physician visits from the National Ambulatory Medical Care Survey (NAMCS) 1993-1998 and compared ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(02)00213-x
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:Oral loading with the delayed release formulation of divalproex sodium is widely used for the treatment of patients with acute mania and produces rapid attainment of therapeutic serum levels. Recently, an extended release formulation of divalproex sodium (divalproex ER) was approved for treatment of migraine...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2005.02.001
更新日期：2005-05-01 00:00:00
abstract：:Psychological intervention studies designed to reduce cardiac morbidity are reviewed. Preliminary findings suggest that various psychotherapeutic modalities may be effective. Such studies also provide an avenue through which the physical and psychological mechanisms involved in coronary heart disease and their interac...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(79)90074-4
更新日期：1979-04-01 00:00:00
abstract：:Linkages between psychiatry and other medical specialties have become increasingly evident over the past decade. Reinstatement of the medical internship for psychiatric trainees, expansion of psychiatric liaison services, growth of general hospital psychiatric units, determination of the extensive role served by nonps...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：OBJECTIVE:Demonstrate the feasibility of implementing a collaborative care program for poorly-controlled type 2 diabetes and complex behavioral health disorders in an urban academically-affiliated safety net primary care clinic. METHODS:This retrospective cohort study evaluates multidisciplinary team care approach to ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2016.10.005
更新日期：2017-01-01 00:00:00
abstract：:Outpatient consultation-liaison (C-L) psychiatry has been beset with problems concerning funding and patient acceptance. Though the consultation, liaison, and referral clinic models for outpatient C-L psychiatry each offer advantages, they have not conquered these fundamental problems. This paper introduces the multid...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(93)90005-9
更新日期：1993-11-01 00:00:00
abstract：:Critical, intertwined objectives for consultation psychiatry include 1) the development of data-based clinical practices, and 2) heightening the effectiveness of consultation. Toward these ends, the Consultation Psychiatry Service at the University of Minnesota has previously conducted systematic studies of consultati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90020-9
更新日期：1985-04-01 00:00:00
abstract：OBJECTIVE:Integrating primary care services into specialty mental health clinics has been proposed as a method for improving health care utilization for medical conditions by adults with serious mental illness. This paper examines the impact of a mental health based primary care program on emergency department (ED) vis...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.02.008
更新日期：2018-01-01 00:00:00
abstract：:The differential diagnosis of hypercortisolemia is complex, particularly when the clinician must distinguish Cushing's syndrome (CS) from major depression. The present clinical case history demonstrates that by means of physical and laboratory examinations, the psychiatrist can make the initial differentiation, in con...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(95)00063-w
更新日期：1995-09-01 00:00:00
abstract：:Most low-income minority women do not obtain screening mammography on a regular basis. Compliance with recommended breast cancer screening guidelines may be even lower in women with psychiatric illnesses. We investigated compliance with breast cancer screening guidelines among 121 ethnically diverse low-income women r...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(99)00036-5
更新日期：1999-09-01 00:00:00
abstract：:In this study, 96 frequent attender patients in primary care were compared with 466 other primary care patients. The focus was on psychiatric morbidity, current and former psychiatric treatment, and self-perceived need for treatment. The prevalence of psychiatric illness was much greater among frequent attender patien...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(94)00059-m
更新日期：1995-01-01 00:00:00
abstract：:Appreciation of the role of milieu in psychiatry has waxed and waned in response to various scientific, ideologic, and social pressures. In this review, historical trends in the use of environment in treatment of mental illness are integrated with social science and empirical research studies of milieu. While the insi...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(82)90030-5
更新日期：1982-04-01 00:00:00
