全科医生对常见精神障碍的认识和管理：来自巴基斯坦卡拉奇的一项基于社区的调查。

General practitioners' awareness and management of common psychiatric disorders: a community-based survey from Karachi, Pakistan.

机构信息

Department of Psychiatry, Aga Khan University, Karachi, Pakistan.

出版信息

East Mediterr Health J. 2012 May;18(5):446-53. doi: 10.26719/2012.18.5.446.

DOI:10.26719/2012.18.5.446

Abstract

This study assessed the knowledge and management of common psychiatric disorders by general practitioners (GPs) in Karachi, Pakistan. Structured interviews were carried out in 2009 with 360 GPs selected by cluster random sampling. Patients with psychiatric disorders were estimated to be up to 10% of the daily caseload according to 71.8% of doctors. Two-thirds of GPs were unaware of the ICD-10 diagnostic criteria for depression and anxiety disorders. Benzodiazepines were the most recognized category of medication (75.3%) and were the most commonly used medication for all mental health conditions. Fewer GPs were familiar with selective serotonin reuptake inhibitors (35.1%) or tricyclic antidepressants (20.2%). Lack of time and patients' financial constraints were reported to be barriers to care. Most GPs (69.2%) had not received any recent medical education about mental health problems. Gaps in GPs' knowledge about the management of mental disorders have implications for the rational use of psychotropic medications in primary care.

摘要

本研究评估了巴基斯坦卡拉奇的全科医生（GP）对常见精神障碍的知识和管理情况。2009 年采用整群随机抽样方法选择了 360 名全科医生进行了结构访谈。根据 71.8%的医生的估计，精神障碍患者占每日工作量的 10%。三分之二的全科医生不了解抑郁症和焦虑障碍的 ICD-10 诊断标准。苯二氮䓬类药物是最被认可的药物类别（75.3%），也是所有精神健康状况最常用的药物。熟悉选择性 5-羟色胺再摄取抑制剂（35.1%）或三环类抗抑郁药（20.2%）的医生较少。缺乏时间和患者的经济限制被认为是提供医疗服务的障碍。大多数全科医生（69.2%）最近没有接受过任何关于精神健康问题的医学教育。全科医生在精神障碍管理方面的知识差距对精神药物在初级保健中的合理使用有影响。