Stoudemire A
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Psychosomatics. 1996 Nov-Dec;37(6):502-8. doi: 10.1016/S0033-3182(96)71513-X.
In an effort to control the costs of mental health care, many medical care systems have emphasized the management of psychiatric illness by primary care physicians and curtailed specialty mental health referrals. While this trend mandates that primary care physicians have expertise in the diagnosis and treatment of psychiatric disorders, evidence indicates that not only are psychiatric disorders underrecognized in primary care settings, but also that treatment is often inadequate and accompanied by less than optimal outcomes. In Part 1 of this 2-part series, representative studies of the epidemiology of psychiatric disorders in primary care are reviewed in addition to data that has documented low rates of recognition and suboptimal management of psychiatric illness. In Part 2, to be published in the January-February 1997 issue of Psychosomatics, a core psychiatric curriculum for primary care physicians will be presented that emphasizes the use of competency-based training modules. Strategies for the development and implementation of these educational training modules will also be discussed.
为了控制精神卫生保健成本，许多医疗保健系统强调由初级保健医生管理精神疾病，并减少了转介到精神科专科治疗的情况。虽然这一趋势要求初级保健医生具备诊断和治疗精神障碍的专业知识，但有证据表明，不仅在初级保健机构中精神障碍未得到充分认识，而且治疗往往不足，效果也不尽如人意。在这个两部分系列文章的第一部分中，除了记录精神疾病识别率低和管理欠佳的数据外，还对初级保健中精神障碍流行病学的代表性研究进行了综述。第二部分将于1997年1月至2月在《心身医学》杂志上发表，将介绍一个面向初级保健医生的核心精神科课程，该课程强调使用基于能力的培训模块。还将讨论这些教育培训模块的开发和实施策略。
