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Checklists for general practitioner diagnosis of depression in adults with intellectual disability
- Authors:
- TORR J., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 52(11), November 2008, pp.930-941.
- Publisher:
- Wiley
In Australia, diagnosis and management of depression in adults with intellectual disability (ID) often occurs within the primary care setting. Few tools are available to assist general practitioners (GPs) in the diagnostic process. The study aim was to assess properties of carer and GP checklists developed to address this problem. Participants were 49 adults with ID and their paid carers (support workers), and GPs for 27 adults. Data from carer and GP checklists were gathered, in addition to carer completed Developmental Behaviour Checklist – Adults (DBC-A). Adults with ID also received a comprehensive psychiatric assessment. Both checklists demonstrated good internal consistency (KRS-20 = 0.90). A factor analysis of the carer checklist indicated a single factor on which three section totals had loadings of greater than 0.722 (depressed mood, loss of interest, and social interaction and communication). This factor was interpreted to be depression. The GP checklist data were insufficient for factor analysis, but section totals were moderately correlated with most corresponding carer checklist section totals. Carer section totals related to depression also correlated highly with the DBC-A Depression sub-scale, demonstrating good concurrent validity. Contrasting results were obtained for the GP checklist. Most (n = 42) of the participants were diagnosed with a psychiatric disorder, precluding the testing of checklist specificity and sensitivity. The carer checklist shows promise as a means of gathering information needed by a GP in the diagnosis of depression in adults with ID. Further research into its underlying properties and clinical uses of a combined depression checklist is warranted.
Detection of child mental health disorders by general practitioners
- Authors:
- SAYAL Kapil, TAYLOR Eric
- Journal article citation:
- British Journal of General Practice, 54(502), May 2004, pp.348-352.
- Publisher:
- Royal College of General Practitioners
This study compares GP recognition of disorders with child mental health data and examines factors affecting recognition, in particular whether recognition is enhanced if the parent expresses concern during the consultation. The study involved a two-phase design involving an initial community survey of children between the ages of 5 and 11 years. In the second phase, primary care attenders who were regarded by their GP as having a mental health disorder were compared with those who were not. For 186 children attending primary care, GP recognition was compared with the results of a child mental health questionnaire completed by parents. Accuracy and predictors of GP recognition were examined. Seventy four percent of children meeting criteria for caseness were not recognised by GP's as having a mental health disorder. The expression of parental concern in the consultation about a mental health problem increased the sensitivity of recognition from 26% to 88%. Expression of concern also increased GP recognition of non-cases; this reflected GP identification of other mental health and learning problems. Only a third of parents who had concerns expressed these during the consultation.
The same but different
- Author:
- TURNBULL John
- Journal article citation:
- Nursing Times, 16.8.95, 1995, p.50.
- Publisher:
- Nursing Times
Why do people with learning disabilities often receive inferior health care in the community compared with the rest of the population. Calls for an end to this thoughtless practice.
Evaluation of a nurse led annual review of patients with severe intellectual disabilities, needs identified and needs met, in a large group practice
- Authors:
- MARTIN Graham, et al
- Journal article citation:
- Journal of Learning Disabilities, 8(3), September 2004, pp.235-246.
- Publisher:
- Sage
A learning disabilities nurse led health review, with doctor backup, was offered to patients with learning disabilities during 2002 in a large general practice. Prior to the check, patients completed an agenda sheet. During the check, the nurse discussed issues with patient and carer and completed a structured questionnaire. Patient and carer were then seen by doctor and nurse and the implementation sheet was completed. Fifty-three patients attended, an uptake of 91 percent. Of these patients and their carers, 34 percent recorded agendas/concerns. The nurse/GP questionnaire identified further interventions in 62 percent. A total of 79 interventions were identified, an average of 1.49 per patient attendance. At 3 months, 84 percent of patients with patient/carer generated, and 88 percent of patients with clinician generated interventions, had had one or more actions implemented. The check met the majority of identified unmet health needs in these adults with learning disabilities. Annual checks will continue to be offered.
'Feeling poorly': report of a pilot study aimed to increase the ability of people with learning disabilities to understand and communicate about physical illness
- Authors:
- DODD Karen, BRUNKER Jo
- Journal article citation:
- British Journal of Learning Disabilities, 27(1), 1999, pp.10-15.
- Publisher:
- Wiley
This article presents the findings of a pilot study which investigated whether people with learning disabilities can understand and communicate more effectively symptoms of illness. Assessments for GPs, clients and carers were designed in order to ascertain the nature of consultations currently taking place, and the level of awareness that clients had of their body and being ill. Also looks at the assessment and teaching resource developed for the project.
Primary care for people with an intellectual disability - a group practice survey
- Authors:
- KERR M.P., RICHARDS D., GLOVER Geraldine
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 9(4), 1996, pp.347-352.
- Publisher:
- Wiley
Describes the process of identification and subsequent examination of the delivery of health care to people with an intellectual disability in a single general practice. The study was undertaken in group practice with a list size of 11,425. Identification through practice and community intellectual disability teams was followed by a note-base assessment of health promotion and consultation rates. Comparison was made with age-sex matched non-disabled controls. Reports on the survey findings.