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Mental Health in Family Medicine

Matthew J Smith, Jan S Greenberg, Sarah A Sciortino, Gisela M Sandoval, Ellen P Lukens
BACKGROUND: Research suggests siblings of individuals with schizophrenia are at a heightened risk for depressive symptomatology. Research has not yet examined whether the strains of growing up with a brother or sister with schizophrenia contribute to this risk. This study examined whether early life course burdens associated with an emerging mental illness, and current objective and subjective caregiver burden predicted depressive symptoms in siblings of individuals with schizophrenia...
2016: Mental Health in Family Medicine
Maria C Colon-Gonzalez, Jennifer S McCall-Hosenfeld, Carol S Weisman, Marianne M Hillemeier, Amanda N Perry, Cynthia H Chuang
OBJECTIVE: Little is known about how primary care providers (PCPs) approach mental health care for low-income rural women. We developed a qualitative research study to explore the attitudes and practices of PCPs regarding the care of mood and anxiety disorders in rural women. METHOD: We conducted semi-structured interviews with 19 family physicians, internists, and obstetrician-gynecologists (OBGYNs) in office-based practices in rural central Pennsylvania. Using thematic analysis, investigators developed a coding scheme...
December 2013: Mental Health in Family Medicine
Boadie W Dunlop, Kelly Scheinberg, Anne L Dunlop
Complaints of depression and anxiety are very common among adult patients seeking treatment in primary care settings, and primary care providers prescribe the majority of medications for these conditions. Psychiatrists are often asked to evaluate and manage patients with major depression or anxiety disorders who have not improved after treatment in primary care. We highlight ten frequently overlooked aspects of the care of patients who present with depression and anxiety in primary care. Chief among these aspects is the consideration of a thorough differential diagnosis, particularly bipolar disorder, psychotic disorders, dementia and substance abuse, each of which requires specific treatment approaches...
September 2013: Mental Health in Family Medicine
Henry Brodaty, Louisa Hr Gibson, Melissa L Waine, Allan M Shell, Ruth Lilian, Constance Dimity Pond
Background Recruitment rates of general practitioners (GPs) to do research vary widely. This may be related to the ability of a study to incorporate incentives for GPs and minimise barriers to participation. Method A convenience sample of 30 GPs, ten each from the Sydney intervention and control groups Ageing in General Practice 'Detection and Management of Dementia' project (GP project) and 10 GPs who had refused participation, were recruited to determine incentives and barriers to participating in research...
September 2013: Mental Health in Family Medicine
Syahnaz Mohd Hashim, Tan Chai Eng, Noorlaili Tohit, Suzaily Wahab
Bereavement in the elderly is a concern to primary care physicians (PCPs) as it can lead to psychological illness such as depression. Most people are able to come to terms with their grief without any intervention, but some people are not. This case highlights the importance of early recognition of bereavement-related depressive illness in elderly people. PCPs need to optimise support and available resources prior to, and throughout, the bereavement period in order to reduce the family members' burden and suffering...
September 2013: Mental Health in Family Medicine
Vasco Nogueira, Luísa Lagarto, Joaquim Cerejeira, Susana Renca, Horácio Firmino
Introduction Elderly patients occupy up to 65% of acute hospital beds and a significant proportion of them present with a comorbid psychiatric condition such as depression, delirium or dementia. Liaison old age psychiatry (LOAP) services have been developed to provide psychiatric consultation in medical and surgical settings, improving at the same time the knowledge and expertise of general ward staff. Objective The aim of this study is to evaluate clinical characteristics across different psychiatric disorders among elderly patients in medical wards...
September 2013: Mental Health in Family Medicine
Chris Fox, Ian Maidment, Esme Moniz-Cook, Jacquie White, Jochen René Thyrian, John Young, Cornelius Katona, Carolyn A Chew-Graham
This review considers key areas in primary care regarding the diagnosis of dementia. Issues surrounding assessment, policy and incentives are considered. In addition, the relevance of non-medication approaches for dementia in primary care, which aim to enhance or maintain quality of life by maximising psychological and social function in the context of existing disabilities, is deliberated. Finally, key issues about primary care medication management are considered, and relevant therapeutic strategies with recommendation for a collaborative approach that improve outcomes by linking primary and secondary healthcare services - including general practice and pharmacy - with social care needs are weighed up...
September 2013: Mental Health in Family Medicine
Shulin Chen, Lisa L Boyle, Yeates Conwell, Helen Chiu, Lydia Li, Shuiyuan Xiao
Dementia is a major cause of disability and has immense cost implications for the individual suffering from the condition, family caregivers and society. Given the high prevalence of dementia in China with its enormous and rapidly expanding population of elderly adults, it is necessary to develop and test approaches to the care for patients with this disorder. The need is especially great in rural China where access to mental healthcare is limited, with the task made more complex by social and economic reforms over the last 30 years that have transformed the Chinese family support system, family values and health delivery systems...
September 2013: Mental Health in Family Medicine
Ct Sudhir Kumar, Jacob Roy Kuriakose
Appropriate management of advanced dementia requires it to be recognised as a terminal condition that needs palliative care. Interventions during this stage should be carefully chosen to ensure the improvement or maintenance of the quality of life of the person with dementia. Advanced care planning is an important aspect of dementia care. Carers and relatives should be educated and encouraged to actively participate in discussions related to artificial nutrition, cardiopulmonary resuscitation (CPR) and other medical interventions...
September 2013: Mental Health in Family Medicine
Carlos Augusto de Mendonça Lima, Gabriel Ivbijaro
No abstract text is available yet for this article.
September 2013: Mental Health in Family Medicine
Andrea Pusey-Murray, Paul Miller
The findings reported here form part of a larger research project that examined non-compliance with medication among the mentally ill patients attending public clinics in a specific parish in Jamaica. The aim of the research was to explore the perceptions of caregivers about caring for the mentally ill at two outpatient psychiatric clinics. Caregivers involved in looking after their relatives with mental illness played a vital role in mental health promotion. This study sought to examine the caregivers' perception of mental illness, including how they thought the illness was best controlled, the reasons why their relatives found it difficult to take their medication as instructed, and the coping skills that they employed when caring for their relatives...
June 2013: Mental Health in Family Medicine
Louise Stone
Background General practitioners often encounter patients with medically unexplained symptoms. These patients share many common features, but there is little agreement about the best diagnostic framework for describing them. Aims This study aimed to explore how GPs make sense of medically unexplained symptoms. Design Semi-structured interviews were conducted with 24 GPs. Each participant was asked to describe a patient with medically unexplained symptoms and discuss their assessment and management. Setting The study was conducted among GPs from teaching practices across Australia...
June 2013: Mental Health in Family Medicine
Brian Rush, Catherine McPherson-Doe, Reneé C Behrooz, Alan Cudmore
Approximately 200 Family Health Teams (FHTs) have been implemented in Ontario to improve access to primary healthcare, including mental health and addiction. The objectives of this project were to examine, through a focus group and qualitative methodology with three FHTs, the profile of patients' mental health and addiction-related needs and to identify the implications for the development of core competencies in these innovative organisations. A spectrum of needs and service trajectories was identified, as well as the importance of a wide range of clinical skills and knowledge...
June 2013: Mental Health in Family Medicine
Rg Maharaj, C Alexander, C H Bridglal, A Edwards, H Mohammed, Ta Rampaul, S Sanchez, Gp Tanwing, K Thomas
Objectives Somatoform disorders are common in international primary care settings, but have been little studied in the developing world. The objective of this study was to determine the prevalence of severe undifferentiated somatoform disorder, and its relationship to depression and anxiety, among patients attending walk-in clinics in Trinidad. Methods The study participants, who were all aged 18 years or older and attending walk-in clinics at 16 randomly selected health centres, were surveyed between May and August 2007 using the PRIME-MD questionnaire...
June 2013: Mental Health in Family Medicine
José Nunes, Teresa Ventura, Ricardo Encarnação, Patrícia Rosado Pinto, Isabel Santos
Context Medically unexplained physical symptoms (MUPS) are frequently encountered in family medicine, and lead to disability, discomfort, medicalisation, iatrogenesis and economic costs. They cause professionals to feel insecure and frustrated and patients to feel dissatisfied and misunderstood. Doctors seek answers for rather than with the patient. Objectives This study aimed to explore patients' explanations of the medically unexplained physical symptoms that they were experiencing by eliciting their own explanations for their complaints, their associated fears, their expectations of the consultation, changes in their ideas of causality, and the therapeutic approach that they considered would be useful...
June 2013: Mental Health in Family Medicine
Anthony Stern
No abstract text is available yet for this article.
June 2013: Mental Health in Family Medicine
Gabriel Ivbijaro, David Goldberg
No abstract text is available yet for this article.
June 2013: Mental Health in Family Medicine
Patrick McHugh, John Brennan, Niall Galligan, Claire McGonagle, Michael Byrne
Aims This study aimed to examine the effectiveness of a primary care adult mental health service operating within a stepped care model of service delivery. Methods Supervised by a principal psychologist manager, psychology graduate practitioners provided one-to-one brief cognitive behavioural therapy (CBT) to service users. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was used to assess service user treatment outcomes. Satisfaction questionnaires were administered to service users and referring general practitioners (GPs)...
January 2013: Mental Health in Family Medicine
A M Kobus, J Heintzman, R D Garvin
Background and objectives The purpose of this paper is to describe the use of resident performance on an observed structured clinical examination (OSCE) as a tool to refine a mood disorders curriculum, and to disseminate a mood disorders OSCE for use in other residency settings. Methods A depression-focused OSCE and a direct observation evaluation tool were developed and implemented. A total of 24 first-year family medicine residents (PGY1) participated in the OSCE, and their performance was used to direct changes in a mood disorders curriculum...
January 2013: Mental Health in Family Medicine
Sa Jacob, Mi Mohamed Ibrahim, F Mohammed
The present study was conducted primarily to determine the occurrence of polypharmacy in patients with schizophrenia on risperidone. The secondary aim was to ascertain the incidence of inappropriate prescribing with anticholinergics. A retrospective review of the medical records of all patients who were being followed up at the out-patient clinic of a tertiary-care hospital in Malaysia was conducted. Only patients who were being prescribed risperidone between 1 June 2008 and 31 December 2008 were included in the study...
January 2013: Mental Health in Family Medicine
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