Search results for ‘Subject term:"mental health problems"’ Sort:
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Seasonal affective disorder among primary care attenders and a community sample in Aberdeen
- Authors:
- EAGLES J. M., et al
- Journal article citation:
- British Journal of Psychiatry, 175, November 1999, pp.472-475.
- Publisher:
- Cambridge University Press
Patients aged 16-64 consulting their GPs in Aberdeen during January were screened with the Seasonal Pattern Assessment Questionnaire (SPAQ). SPAQs were also mailed to 600 matched patients, who had not consulted their GP during January. Surgery attenders who fulfilled SPAQ criteria for SAD were invited for interview to determine whether they met criteria for SAD in DSM-IV and the Structured Interview Guide for the Hamilton Rating Scale for Depression--Seasonal Affective Disorder Version (SIGH-SAD). Of 6161 surgery attenders, 4557 (74%) completed a SPAQ; 442 (9.7%) were SPAQ cases of SAD. Rate of caseness on the SPAQ did not differ between surgery attenders and non-attenders. Of 223 interviewed SPAQ cases of SAD, 91 (41%) also fulfilled DSM-IV and SIGH-SAD criteria. It is concluded that there is a high prevalence of SAD among patients attending their GPs in January in Aberdeen; this is likely to reflect a similar rate in the community.
Can CORE assessment data identify those clients less likely to benefit from brief counselling in primary care?
- Authors:
- SAXON David, IVEY Catherine, YOUNG Tracey
- Journal article citation:
- Counselling and Psychotherapy Research, 8(4), December 2008, pp.223-230.
- Publisher:
- Wiley
Studies show that counsellors in primary care see many clients with difficulties of a severity similar to those found in secondary care services. Evidence from both RCTs and studies of routinely collected data indicates that many of these 'clinical' clients benefit from brief counselling intervention. However, little is known about why some benefit while others fail to do so despite completing their counselling contract. This paper considers client characteristics recorded at assessment and aims, using logistic regression analysis, to identify those characteristics predictive of a poor outcome. Results indicate that a number of characteristics are associated with poor outcome; the most important predictors are economic inactivity and aspects of the patient's condition, particularly continuous/recurrent depression, with some differences between genders. However, the models produced were not acceptable in their predictive power. This may be partly due to data quality issues or important characteristics not being available in the data. The paper concludes that being unemployed or on state benefits may be a proxy measure of severity that has an important impact on outcome for all patients, and particularly for males. Some reasons are suggested and areas of future research are identified.
Developing social prescribing and community referrals for mental health in Scotland
- Authors:
- FRIEDLI Lynne, et al
- Publisher:
- Scottish Development Centre for Mental Health
- Publication year:
- 2007
- Pagination:
- 97p.
- Place of publication:
- Edinburgh
This report was commissioned from the Scottish Development Centre for Mental Health (SDC) by the Scottish Government’s National Programme for Improving Mental Health and Wellbeing, to address the role and potential contribution of social prescribing or community referral in two principal areas of concern in mental health: effective identification and response to people with common mental health problems presenting in primary care, and the role of primary care in supporting people with long term mental health problems. The aim of this report is to provide information that could inform the future development, commissioning and design of social prescribing or community referral programmes in Scotland.
The effectiveness of case-finding for mental health problems in primary care
- Author:
- MaGPIe Research Group
- Journal article citation:
- British Journal of General Practice, 55(518), September 2005, pp.665-669.
- Publisher:
- Royal College of General Practitioners
This study explores the efficacy of screening and case-finding for high prevalence psychological disorders in routine general practice in New Zealand. Consecutive patients from a random sample of GPs were screened using the General Health Questionairre (GHQ-12). A stratified random sample of patients was selected, based on GHQ strata, and invited to participate in an indepth interview to assess their psychological health. Seventy GPs (90% response) and 775 patients (68.5% response) were included in analyses. Patients' GHQ-12 scores were compared with GP assessment of patients' psychological health using a 5-point scale of severity, and with the Composite International Diagnostic Interview (CIDI 1-month assessment). Results: Overall 17.5% of patients reached the threshold for CIDI diagnosis. GPs identified at least some psychological symptoms in the past 12 months in 70.3% of patients reaching the CIDI threshold for diagnosis. Case-finding with a 'perfect' screening instrument had the potential to identify only five new cases per 100. The sensitivity and specificity of the GHQ-12 suggest it is not an appropriate tool for case finding in a general practice setting. The study concludes that the potential value of any screening and case-finding instrument in routine general practice must be considered in the context of current high rates of identification. Where continuity of care is a feature of usual management, case-finding is most efficient when focused on patients the GP has not seen in the past year.
Deprivation, psychological distress and consultation length in general practice
- Authors:
- STIRLING A.M., WILSON P., McCONNACHIE A.
- Journal article citation:
- British Journal of General Practice, 51(467), June 2001, pp.456-460.
- Publisher:
- Royal College of General Practitioners
The CORE-10: a short measure of psychological distress for routine use in the psychological therapies
- Authors:
- BARKHAM Michael, et al
- Journal article citation:
- Counselling and Psychotherapy Research, 13(1), 2013, pp.3-13.
- Publisher:
- Wiley
Background: There is a need for a generic, short, and easy-to-use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE-10 in response to this need. Method: Items were drawn from the CORE-OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE-OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow-up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE-10 in its standalone format. Results: The internal reliability (alpha) of the CORE-10 was .90 and the score for the CORE-10 correlated with the CORE-OM at .94 in a clinical sample and .92 in a non-clinical sample. The clinical cut-off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut-off score for the CORE-10 was 13 and yielded sensitivity and specificity values of .92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion: The CORE-10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings. (Publisher abstract)
Audit as discovery: context and complexity in secondary-to-primary care mental health service users
- Authors:
- FIRTH Malcolm Thomas, POWLING Laura, WITTER Martina
- Journal article citation:
- Journal of Social Work Practice, 26(3), 2012, pp.283-299.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Audit processes are commonly used to ascertain productivity, quality assurance and consumer satisfaction or, more narrowly, to check that practitioners are correctly adhering to service protocols. However, audit can also be a means for practitioners themselves to shed light on their own practices. In this study, data are explored from two very different mental health services, one in primary care (PC) the other in secondary care (SC), with a common clientele. Demographic, risk, health and social need factors were identified from 36 service users who had previously been receiving a service from a crisis resolution or community mental health team, or from a psychology service. Depression and/or anxiety characterised the mental health problems of the majority of primary care service users, although all were experiencing complex, multiple adversities. Risk factors were similar between the services, as were health and social care needs, suggesting that primary care service users' quality of life was little different than when seen earlier in secondary care. Collectively, primary care service users had marked difficulties with psychological health, daily occupation, physical health, money, unemployment and personal and social isolation. At the individual level, however, ‘complexity’ was evident but inadequately captured by the audit methodology, the latter being too remote from user and worker contexts. The authors concluded that recognition of context-based complexity may more usefully inform practitioners' interventions than talking therapies or evidence-based practice alone.
Guided self-help supported by paraprofessional mental health workers: an uncontrolled before-after cohort study
- Authors:
- FARRAND Paul, et al
- Journal article citation:
- Health and Social Care in the Community, 17(1), February 2009, pp.9-17.
- Publisher:
- Wiley
There has been considerable development of guided self-help clinics within primary care. This uncontrolled before–after cohort study examines efficiency and effectiveness of these clinics when supported by paraprofessional mental health workers having little mental health training and experience. Data were collected by seven Graduate Mental Health Workers (GMHW) located in South-west England. Alongside an analysis of clinic attendance and dropout, efficiency was measured with respect to the number and length of sessions to support patients with the effectiveness of the interventions examined with respect to problem severity. Over a 15-month period, 1162 patients were referred to the GMHW clinics with 658 adopting guided self-help. Patients using guided self-help received an average input per patient, excluding assessment, of four sessions of 40 minutes. Dropout rate was comparable to other primary-care-based mental health clinics supported by experienced mental health professionals with 458 patients completing all support sessions. However, only 233 patients went on to attend the 3 months of follow-up session. Effectiveness of guided self-help clinics supported by paraprofessional mental health workers was comparable to that supported by an experienced mental health nurse. Improvements in problem severity were statistically significant, with 55% and 58% (final support session) and 63% and 62% (3 months of follow-up) of patients experiencing clinically significant and reliable change for anxiety and depression, respectively. However, concerns exist over the efficiency of the GMHW clinic especially with respect to the use of longer support sessions and high dropout rate at the 3 months of follow-up session. The paper concludes by highlighting the effectiveness of guided self-help when supported by paraprofessional mental health workers, but questions the utility of the two-plus-one model of service delivery proposing a collaborative care approach as an alternative.
Parents, mental illness, and the primary health care of infants and young children
- Author:
- CONSTANTINO John N.
- Publisher:
- National Center for Clinical Infant Programs
- Publication year:
- 1993
- Pagination:
- 39p.
- Place of publication:
- Arlington, VA
Examines psychiatric complications of medical disorders and depression in parents and how this affects early parent-child relationships.
The European Early Promotion Project: description of the service and evaluation study
- Authors:
- PUURA Kaija, et al
- Journal article citation:
- International Journal of Mental Health Promotion, 7(1), February 2005, pp.17-31.
- Publisher:
- Taylor and Francis
Describes an innovative cross-cultural method of working with families to promote the psychosocial wellbeing of children and prevent the development of psychological and social problems. Also presents a study designed to evaluate the effects of the service. Primary health care workers in 5 countries of northern, central and southern Europe were trained to conduct promotional interviews with all prospective mothers in their area one month before and one month after birth. They were also taught to work with mothers identified as in need of support as a parent, using a specific counselling model to try to prevent the onset of child mental health difficulties. Effects of the intervention on children's psychological development and family adaptation were evaluated at 2 years of age in comparison with matched groups not receiving the intervention, using a set of questionnaires, interviews and observation methods. The total sample at initial assessment was 824 families, of which 705 (85.65) were retained for outcome assessment. Part of a special issue on the European Early Promotion Project (EEPP).