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全科医疗中心理健康问题的治疗:所开具精神药物及提供的其他治疗的调查

Treatment of mental health problems in general practice: a survey of psychotropics prescribed and other treatments provided.

作者信息

van Rijswijk E, Borghuis M, van de Lisdonk E, Zitman F, van Weel C

机构信息

Department of General Practice, University Medical Center St. Radboud, Nijmegen, The Netherlands.

出版信息

Int J Clin Pharmacol Ther. 2007 Jan;45(1):23-9. doi: 10.5414/cpp45023.

Abstract

OBJECTIVE

Real-life data on the treatment of patients with mental health problems are important as a reference to evaluate care and benchmarking. This study describes the treatment of mental health problems in general practice as diagnosed by general practitioners (GP).

MATERIAL AND METHODS

Data on mental health problems were available from structured psychiatric interviews in the general population and data on mental health problems diagnosed by general practitioners. Pharmacological and non-pharmacological treatment data were taken from patients records held electronically in general practices.

RESULTS

GPs diagnosed a mental health problem in 13.2% of the 1,756 cases examined and 86% of these patients were treated by the GPs themselves. Of the 16% referrals, the majority were referred within primary care. Nearly all patients with a mental health problem received counseling or advice from their GP. Half of the patients with a medication-related disorder, a (single) mood disorder or an (single) anxiety disorder and all patients with a combined anxiety and depressive disorder received a prescription for psychotropic drugs (antidepressants and/or benzodiazepines). Nearly all patients with a sleep disorder received a prescription for benzodiazepine. In patients with psychosocial problems, 20% received benzodiazepines.

CONCLUSION

The majority of mental health problems, when professionally treated, are treated in primary care. More than half the patients are treated with antidepressants and/or benzodiazepines. Most patients also receive supportive counseling or advice.

摘要

目的

有关心理健康问题患者治疗的实际数据对于评估医疗服务和进行基准比对具有重要的参考价值。本研究描述了全科医生(GP)所诊断的心理健康问题在全科医疗中的治疗情况。

材料与方法

心理健康问题的数据来自普通人群的结构化精神病学访谈以及全科医生诊断的心理健康问题数据。药物和非药物治疗数据取自全科医疗中以电子方式保存的患者记录。

结果

在1756例接受检查的病例中,全科医生诊断出13.2%的患者存在心理健康问题,其中86%的患者由全科医生亲自治疗。在16%的转诊病例中,大多数是在初级医疗体系内转诊。几乎所有存在心理健康问题的患者都从其全科医生那里获得了咨询或建议。患有药物相关障碍、(单一)心境障碍或(单一)焦虑障碍的患者中有一半以及所有患有焦虑抑郁混合障碍的患者都收到了精神药物(抗抑郁药和/或苯二氮䓬类药物)的处方。几乎所有患有睡眠障碍的患者都收到了苯二氮䓬类药物的处方。在有社会心理问题的患者中,20%的患者收到了苯二氮䓬类药物。

结论

大多数心理健康问题在接受专业治疗时是在初级医疗中进行的。超过一半的患者接受了抗抑郁药和/或苯二氮䓬类药物治疗。大多数患者还接受了支持性咨询或建议。

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