DETERMINANTS of COMMON MENTAL DISORDERS DETECTION BY GENERAL PRACTITIONERS in the PRIMARY HEALTH CARE in BRAZIL

DETERMINANTS of COMMON MENTAL DISORDERS DETECTION BY GENERAL PRACTITIONERS in the PRIMARY HEALTH CARE in BRAZIL

Author Goncalves, Daniel A. Autor UNIFESP Google Scholar
Fortes, Sandra Google Scholar
Tofoli, Luis Fernando Google Scholar
Campos, Monica Rodrigues Google Scholar
Mari, Jair de Jesus Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Kings Coll London
Med Univ Estado Rio de Janeiro
Univ Fed Ceara
Abstract Common Mental Disorders (CIVIC) are highly prevalent among patients attending primary care. Many of these disorders remain unrecognized by general practitioners (GPs), with the detection rates varying from 30 to 60%. This study aims to evaluate the CMD detection rates by Primary Heath Care (PHC) practitioners in Brazil-and factors that affect CMD detection. Methods: A cross sectional study was conducted with users of five PHC units in the city of Petropolis. the CMD prevalence of psychiatric morbidity was estimated by the General Health Questionnaire-12, and the physician's CMD detection was evaluated by a questionnaire completed by GPs after each consultation. Results: Seven hundred and fourteen subjects participated of the study, and 400 (56%) were screened positive using GHQ-12 cut-off point of 2/3. GPs diagnosed 379 people with CMD (53.1%), and 256(36%) subjects were detected by both GHQ and the GPs with an OR of 3.04 (95%CI 2.23-4.13). CMD detection accuracy by GPs was 65%. There was a strong association between the detection of CMD and the report of medically unexplained physical symptoms by GPs. Being female, married, and a frequent service user was also related to higher detection rates. Conclusion: CMD detection rate was similar to those reported worldwide, but contrary to other studies, the presence of MUS increased detection rates. the high frequency of CMD in Primary Health Care highlights the need for improving GP and health worker's training in order to enable them to accurately recognize and treat psychological distress with evidence-based interventions. (Int'l. J. Psychiatry in Medicine 2011;41:3-13)
Keywords primary health care
family health
general practitioner
mental disorders/diagnosis
primary prevention
Language English
Sponsor Pan-American Health Organization
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Date 2011-01-01
Published in International Journal of Psychiatry in Medicine. Amityville: Baywood Publ Co Inc, v. 41, n. 1, p. 3-13, 2011.
ISSN 0091-2174 (Sherpa/Romeo, impact factor)
Publisher Baywood Publ Co Inc
Extent 3-13
Origin http://ijp.sagepub.com/content/41/1/3.abstract
Access rights Closed access
Type Article
Web of Science ID WOS:000288182800002
URI http://repositorio.unifesp.br/handle/11600/33342

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