专攻家庭医学能否改善心理健康问题的检测与诊断？
Does Specializing in Family Medicine Improve the Detection and Diagnosis of Mental Health Problems?
作者信息
Hornik-Lurie Tzipi, Cwikel Julie, Zilber Nelly, Feinson Marjorie C, Biderman Aya, Lerner Yaacov
机构信息
Social Work Department, Ben-Gurion University of the Negev, Beer Sheva, Israel The Falk Institute for Mental Health Studies, Kfar Shaul Hospital, Givat Shaul, Jerusalem, Israel.
Social Work Department, Ben-Gurion University of the Negev, Beer Sheva, Israel Center for Women's Health Studies and Promotion, Ben-Gurion University of the Negev, Beer Sheva, Israel.
出版信息
Isr J Psychiatry Relat Sci. 2016;53(1):63-70.
BACKGROUND
Approximately half the patients seeking mental health (MH) treatment consult primary care practitioners (PCPs). Previous research indicates that patients often do not receive correct MH diagnoses or appropriate treatment from PCPs. The present study examines whether a specialization in family medicine compared to other or no PCP residency programs enhances physicians' ability to detect, diagnose and treat MH problems.
METHODS
Face-to-face interviews with 49 physicans in eight clinics in Israel. Two case vignettes and questionnaires assess MH awareness and factors influencing treatment.
RESULTS
Significantly more family practitioners (FPs) compared to others correctly diagnosed depression and anxiety vignettes were aware of patients' MH problems and prescribed psychotropic drugs.
LIMITATIONS
Small sample size, indirect examination of PCPs' skills using vignettes and the absence of psychotherapy options.
CONCLUSIONS
FPs are more likely than other PCPs to detect, diagnose and treat MH problems. To improve MH detection among a broad range of PCPs, an expanded MH curriculum should be encouraged. Additional MH training should be available for all PCPs.
背景
寻求心理健康（MH）治疗的患者中约有一半会咨询初级保健医生（PCP）。先前的研究表明，患者通常无法从初级保健医生那里获得正确的MH诊断或适当的治疗。本研究旨在探讨与其他或无PCP住院医师培训项目相比，家庭医学专业是否能提高医生检测、诊断和治疗MH问题的能力。
方法
对以色列8家诊所的49名医生进行面对面访谈。通过两个病例 vignettes 和问卷评估MH意识及影响治疗的因素。
结果
与其他医生相比，家庭医生（FP）能更准确地诊断抑郁症和焦虑症 vignettes，了解患者的MH问题并开具精神药物。
局限性
样本量小，使用 vignettes 间接考察PCP的技能，且缺乏心理治疗选项。
结论
家庭医生比其他PCP更有可能检测、诊断和治疗MH问题。为提高广大PCP的MH检测能力，应鼓励扩大MH课程。所有PCP都应接受额外的MH培训。
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