Afana Abdel-hamid, Dalgard Odd Steffen, Bjertness Espen, Grunfeld Berthold
Gaza Community Mental Health Programme, The Gaza Strip, Gaza City, PO Box 1049, Palestine.
J Public Health Med. 2002 Dec;24(4):326-31. doi: 10.1093/pubmed/24.4.326.
The aim of the present study was to investigate the detection rate by general practitioners (GPs) of mental disorders in a primary health care setting and relating the findings to selected GP characteristics and the patient sociodemographic characteristics.
The patients were assessed with respect to mental disorders by Hopkins Symptom Checklist 25 (HSCL-25), and the GPs were independently asked to fill in the Goldberg checklist II to assess the patient after consultation. The sample consisted of 10 primary health care clinics in the Gaza Strip, which were randomly selected from the five regions that form the Gaza Strip (Northern, Southern region, Gaza City, Middle region, Khan-Younis and Rafah). Thirty-two GPs and 661 patients participated in the study.
The study showed that the GPs detected only 11.6 per cent of patients with mental disorders at HSCL-25 score >1.75, and that the GP's assessment was not significantly associated with the HSCL-25 scores. GPs with postgraduate psychiatric training performed better in detecting mental disorders, likewise female GPs and those who were more than 40 years old. The results also revealed that the GPs were more able to detect mental disorders among patients older than 25 years, and in female patients.
The GPs' poor detection rate of mental disorders indicates the importance of mental health training for GPs working in primary health care clinics.
本研究旨在调查基层医疗环境中全科医生（GP）对精神障碍的检出率，并将结果与选定的全科医生特征和患者社会人口学特征相关联。
采用霍普金斯症状清单25项（HSCL - 25）对患者的精神障碍进行评估，同时独立要求全科医生在会诊后填写戈德堡清单II来评估患者。样本包括从构成加沙地带的五个地区（北部、南部地区、加沙市、中部地区、汗尤尼斯和拉法）随机选取的加沙地带的10家基层医疗诊所。32名全科医生和661名患者参与了该研究。
研究表明，全科医生仅检测出HSCL - 25评分>1.75的精神障碍患者中的11.6%，且全科医生的评估与HSCL - 25评分无显著关联。接受过精神科研究生培训的全科医生在检测精神障碍方面表现更好，同样，女性全科医生以及年龄超过40岁的全科医生也是如此。结果还显示，全科医生更能在25岁以上的患者以及女性患者中检测出精神障碍。
全科医生对精神障碍的低检出率表明，对在基层医疗诊所工作的全科医生进行心理健康培训很重要。
