Örüm Dilek
Psychiatry, Elazığ Fethi Sekin City Hospital, Elazığ, Türkiye.
Front Med (Lausanne). 2024 Aug 1;11:1427745. doi: 10.3389/fmed.2024.1427745. eCollection 2024.
Many variables may affect the approaches of primary care providers (PCPs) to mental disorders. This study was aimed at reaching PCPs actively practicing in Turkey through a web-based survey and determining their practices and attitudes regarding mental disorders.
This was a web-based, quantitative, cross-sectional, primary care approach-based observational survey.
Data from 454 PCPs (213 male, 241 female; 321 general practitioners, 133 family medicine specialists) were examined. In-service training in psychiatry ( < 0.001), using classification criteria when evaluating mental disorders ( < 0.001), and experience in diagnosing mental disorders ( = 0.003) were more prevalent among family medicine specialists than general practitioners. Regardless of specialization status, PCPs reported the most difficulty diagnosing bipolar disorder (62.33%) and following-up alcohol/drug use disorder (52.20%). Significant differences in the use of psychotropic medications were observed between general practitioners and family medicine specialists. While the rate of direct referral to psychiatry without intervening in certain situations was higher among general practitioners, variety of psychotropic medication use were also more evident among them. Misinformation that antidepressants cause forgetfulness, numbness, suicide, and addiction was prevalent among all PCPs. Those who had in-service training in psychiatry had significantly more experience in using classification criteria, diagnosing and starting treatment for mental disorders, using psychotropic medications, and encountering suicide-related situations ( < 0.05). Binary logistic regression analysis demonstrated that psychiatry in-service training experience can improve the use of classification criteria, suicide detection, antidepressant choice in anxiety, and understanding the addictive nature of antidepressants (Sensitivity = 88.6%; Specificity = 98.3%; Beginning block -2 Log likelihood 628.946, overall value < 0.001; Block one -2 Log likelihood 141.054, Cox & Snell = 0.659, Nagelkerke = 0.878; Hosmer and Lemeshow Test = 0.938).
This study makes significant contributions to the literature by discussing the subject in detail and comparing general practitioners and family medicine specialists. Regardless of their specialty status, PCPs' knowledge about mental disorders needs to be improved. In-service psychiatry training is one of the tools that can be used for this purpose.
许多变量可能会影响基层医疗服务提供者（PCP）对精神障碍的诊疗方式。本研究旨在通过一项基于网络的调查，联系到在土耳其积极执业的基层医疗服务提供者，并确定他们对精神障碍的诊疗实践和态度。
这是一项基于网络的、定量的、横断面的、基于基层医疗服务方式的观察性调查。
对454名基层医疗服务提供者的数据（213名男性，241名女性；321名全科医生，133名家庭医学专科医生）进行了分析。与全科医生相比，家庭医学专科医生接受过更多的精神病学在职培训（<0.001），在评估精神障碍时使用分类标准的比例更高（<0.001），且诊断精神障碍的经验更丰富（=0.003）。无论专业地位如何，基层医疗服务提供者报告称，诊断双相情感障碍（62.33%）和随访酒精/药物使用障碍（52.20%）最为困难。全科医生和家庭医学专科医生在使用精神药物方面存在显著差异。虽然全科医生在某些情况下不进行干预而直接转诊至精神科的比例较高，但他们使用的精神药物种类也更多。所有基层医疗服务提供者中普遍存在关于抗抑郁药会导致健忘、麻木、自杀和成瘾的错误信息。接受过精神病学在职培训的人员在使用分类标准、诊断和开始治疗精神障碍、使用精神药物以及处理与自杀相关情况方面的经验明显更丰富（<0.05）。二元逻辑回归分析表明，精神病学在职培训经历可改善分类标准的使用、自杀检测、焦虑症中抗抑郁药的选择以及对抗抑郁药成瘾性的理解（敏感性=88.6%；特异性=98.3%；初始块 -2对数似然值628.946，总体p值<0.001；第一个块 -2对数似然值141.054，Cox & Snell R² = 0.659，Nagelkerke R² = 0.878；Hosmer和Lemeshow检验 = 0.938）。
本研究通过详细讨论该主题并比较全科医生和家庭医学专科医生，为文献做出了重要贡献。无论其专业地位如何，基层医疗服务提供者对精神障碍的知识都需要提高。精神病学在职培训是可用于此目的的工具之一。
