Sepúlveda-Muñoz Jesús, Quemada González Casta, Hurtado Lara María M, Gutiérrez García Ángel Manuel, Martí-García Celia, García-Herrera Pérez-Bryan José María, Morales-Asencio José Miguel
Health District Málaga-Guadalhorce, Málaga, Spain.
Unidad Docente de Málaga, Málaga, Spain.
J Prim Care Community Health. 2025 Jan-Dec;16:21501319241306177. doi: 10.1177/21501319241306177.
To investigate the detection and initial management of first psychotic episodes, as well as established schizophrenia, within the primary care of the Andalusian Health System.
Delay in detecting and treating psychosis is associated with slower recovery, higher relapse risk, and poorer long-term outcomes. Often, psychotic episodes go unnoticed for years before a diagnosis is established. Primary care physicians are crucial for early recognition of psychosis and schizophrenia, especially in Spain, where primary care is the main entry point to healthcare services.
Cross-sectional exploratory study. All active primary care physicians in the Malaga Guadalhorce Health District were invited to participate. Due to the COVID-19 pandemic, the survey was conducted online. The survey, adapted and validated for the local context, included 22 items and 5 sociodemographic questions covering early detection, treatment options, physical health monitoring, and management challenges. Descriptive and bivariate analyses summarized the data and explored correlations between key variables.
The study included 142 primary care physicians (response rate 35.5%), with 28.9% men and 71.1% women, primarily from urban areas (83.1%). Most had completed residency training (86.6%), with 79.6% receiving psychiatric training. However, only 5.6% had participated in training sessions in the last 5 years, with all such sessions lasting less than 30 h. Physicians typically managed 0-10 patients with diagnosed schizophrenia and saw these patients 2 to 3 times annually. They often felt capable of managing these patients, especially with mental health consultancy support. Physical health monitoring was common, though some relied on mental health services to do this. Collaboration with mental health services was moderate, with high utility perceived for having a list of patients with severe mental disorders in their care panel.
Family physicians are generally confident in managing psychosis and schizophrenia but lack recent specialized training. Mental health consultancy services are valued, but collaboration with these services needs improvement. Clear guidelines and enhanced training are essential to ensure comprehensive care, addressing both mental and physical health needs of these patients.
调查安达卢西亚卫生系统初级保健中首次精神病发作以及已确诊精神分裂症的检测和初始管理情况。
精神病检测和治疗的延迟与恢复较慢、复发风险较高以及长期预后较差有关。通常，精神病发作在确诊前多年都未被发现。初级保健医生对于精神病和精神分裂症的早期识别至关重要，尤其是在西班牙，初级保健是医疗服务的主要切入点。
横断面探索性研究。邀请了马拉加瓜达尔霍斯健康区所有在职的初级保健医生参与。由于新冠疫情，调查通过在线方式进行。该调查针对当地情况进行了调整和验证，包括22个项目和5个社会人口学问题，涵盖早期检测、治疗选择、身体健康监测和管理挑战。描述性和双变量分析总结了数据，并探索了关键变量之间的相关性。
该研究纳入了142名初级保健医生（回复率35.5%），其中男性占28.9%，女性占71.1%，主要来自城市地区（83.1%）。大多数人完成了住院医师培训（86.6%），79.6%接受过精神病学培训。然而，在过去5年中，只有5.6%的人参加过培训课程，且所有此类课程时长均少于30小时。医生通常管理0至10名已确诊精神分裂症的患者，每年看望这些患者2至3次。他们通常觉得有能力管理这些患者，特别是在有心理健康咨询支持的情况下。身体健康监测很常见，不过有些人依赖心理健康服务来进行此项工作。与心理健康服务的合作程度一般，他们认为在其护理名单中有严重精神障碍患者名单很有用。
家庭医生通常对管理精神病和精神分裂症有信心，但缺乏近期的专业培训。心理健康咨询服务受到重视，但与这些服务的合作需要改进。明确的指导方针和强化培训对于确保全面护理、满足这些患者的身心健康需求至关重要。
