Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
General Practice Research Unit, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
Scand J Prim Health Care. 2020 Jun;38(2):124-131. doi: 10.1080/02813432.2020.1783477. Epub 2020 Jun 27.
To investigate the prevalence and distribution of psychological diagnoses made by general practitioners (GPs) in urban general practice and the related frequency of consultations during 12 consecutive months in Norwegian general practice. A cross-sectional study with data extracted from 16,845 electronic patient records in 35 urban GP practices Six GP group practices in Groruddalen, Norway. All patients aged 16-65 with a registered contact with a GP during 12 months in 2015. Frequency and distribution of psychological diagnoses made by GPs, and the number of patients' consultations. GPs made a psychological diagnosis in 18.8% of the patients. The main diagnostic categories were depression symptoms or disorder, acute stress reaction, anxiety symptoms or disorder and sleep disorder, accounting for 67.1% of all psychological diagnoses given. The mean number of consultations for all patients was 4.09 (95% CI: 4.03, 4.14). The mean number of consultations for patients with a psychological diagnosis was 6.40 (95% CI: 6.22, 6.58) compared to 3.55 (95% CI 3.50, 3.51) (<0.01) for patients without such a diagnosis. Seven percent of the diagnostic variation was due to differences among GPs. Psychological diagnoses are frequent in urban general practice, but they are covered using rather few diagnostic categories. Patients with psychological diagnoses had a significantly higher mean number of GP consultations regardless of age and sex. The knowledge of the burden of psychological health problems in general practice must be strengthened to define evidence-based approaches for detecting, diagnosing and treating mental disorders in the general practice population.Key PointsEighteen percent of patients aged 16-65 in our study of patients in urban general practice received one or more psychological diagnoses in 12 months.Depression was the most common diagnosis; followed by acute stress reaction, anxiety and sleep disturbance.Patients with psychological diagnoses had a significantly higher mean number of consultations compared to patients without such diagnoses regardless of age and sex.
调查 12 个月内挪威城市全科医生（GP）在常规医疗实践中做出的心理诊断的流行率和分布情况，以及相关咨询频率。这是一项横断面研究，数据来自挪威 35 家城市 GP 实践中的 16845 份电子患者记录。所有 16-65 岁的患者，在 2015 年的 12 个月内与 GP 有挂号记录。GP 做出的心理诊断的频率和分布情况，以及患者就诊次数。GP 对 18.8%的患者做出了心理诊断。主要诊断类别为抑郁症状或障碍、急性应激反应、焦虑症状或障碍和睡眠障碍，占所有心理诊断的 67.1%。所有患者的平均就诊次数为 4.09（95%CI：4.03，4.14）。有心理诊断的患者的平均就诊次数为 6.40（95%CI：6.22，6.58），而无此类诊断的患者的平均就诊次数为 3.55（95%CI 3.50，3.51）（<0.01）。诊断差异的 7%归因于 GP 之间的差异。心理诊断在城市全科医疗中很常见，但使用的诊断类别却很少。无论年龄和性别如何，有心理诊断的患者的平均就诊次数明显更高。为了确定针对普通人群中精神障碍的检测、诊断和治疗的循证方法，必须加强对普通医疗实践中心理健康问题负担的了解。关键点在我们对城市全科医疗中患者的 12 个月研究中，18%的 16-65 岁患者接受了一次或多次心理诊断。抑郁症是最常见的诊断；其次是急性应激反应、焦虑和睡眠障碍。与没有此类诊断的患者相比，无论年龄和性别如何，有心理诊断的患者的平均就诊次数明显更高。
