Background Antonovsky's concept of sense of coherence (SOC) has been suggested to relate to health, especially mental health and preventive health behaviours. Psychological distress has been identified as a risk factor for pre-diabetes and type 2 diabetes mellitus. The study of SOC and diabetes has not received much attention in Greece. This study aims to explore the extent to which type 2 diabetes mellitus can affect the SOC score.
Methods An observational design was used to test the study hypothesis that individuals with type 2 diabetes mellitus would have a lower SOC than those without diabetes mellitus. A total of 202 individuals were studied, consisting of 100 people with diabetes mellitus (the study group) and 102 people with non-chronic orthopaedic conditions (the control group). All of the participants were patients of the Diabetic Clinic or the Orthopaedic Clinic of Livadia Hospital in Central Greece. SOC was assessed using a 29-item SOC questionnaire that had been translated into Greek and validated.
Results Patients without type 2 diabetes mellitus had 2.4 times higher odds of having a high SOC score than patients with type 2 diabetes mellitus (P = 0.036; odds ratio [OR] = 2.35, 95% confidence interval [CI] = 1.06–5.23). Male patients had 3.9 times higher odds of having a high SOC score (P < 0.001; OR = 3.85, 95% CI = 1.71–8.67) than female patients. With regard to education, patients with a lower level of education had almost three times higher odds of having a high SOC score than patients with a higher level of education (P = 0.024; OR = 2.97, 95% CI = 1.15–7.67).
Conclusions This study adds to the existing literature and indicates that SOC is a health asset. A study with an experimental design would clarify the interesting hypothesis of this study.
diabetes; sense of coherence; survey
Objective The primary aim of this study was to determine whether enrolment in collaborative care management (CCM) for treatment of major depression would have a significant impact on 6-month changes in weight compared with patients treated by their primary care provider with usual care. The secondary aim was to determine whether clinical remission would also affect 6-month weight changes.
Design A retrospective chart review study included 1550 patients who had been diagnosed with major depression or dysthymia and who had a Patient Health Questionnaire (PHQ-9) score of ≥ 10 with follow-up data (PHQ-9 score and weight) at 6 months.
Subjects The study sample consisted of adult patients (aged ≥ 18 years) from primary care practices, representing all body mass index (BMI) categories. The exclusion criteria were a diagnosis of bipolar disorder, recent obstetric delivery or recent gastric bypass procedure.
Measurements Weight was measured at index and 6 months, with BMI calculated from electronic medical record data. Patient assessment data (including PHQ-9 score and clinical diagnosis) and demographic variables (age, gender, marital status and clinical location) were also collected.
Results With regression modelling, neither enrolment in CCM (P = 0.306) nor clinical remission (P = 0.828) was associated with a significant weight gain.
Conclusion After 6 months, enrolment in CCM had no significant impact on weight gain or weight loss among patients treated for depression, nor was improvement to clinical remission a factor in the patient's weight after 6 months. Incorporating a weight loss management intervention within the model may be warranted if concomitant weight reduction is desired.
collaborative care management; depression; obesity; primary care
Background Slovenian psychiatry is predominantly hospital based. A programme for the development of general community psychiatric services was proposed to improve access to and quality and comprehensiveness of psychiatric care according to the modern standards of delivery of psychiatric services.
Aim The aim of the paper is to present the programme for developing community services that was proposed to the Slovenian government, and to describe the barriers to its implementation that were encountered, as well as the errors made by the programme authors, that contributed to the rejection of the programme last year.
Conclusions There are historical, political, professional and service organisation characteristics that impede the development of community psychiatry in Slovenia. These are to be addressed through coordinated action involving primary care professionals, non-government organisations with service users and carers, the Health Insurance Agency and politicians involved in the planning of health services.
community mental health teams; primary mental healthcare; public mental health indicators
Aims and methods It is now well established that antipsychotic medications are associated with adverse effects such as metabolic dysfunction, hyperprolactinaemia and cardiac arrhythmias. We completed an audit cycle between 2008 and 2010 to assess whether the implementation of a high-visibility prompt and an educational programme would improve monitoring rates among patients prescribed regular antipsychotics admitted to a 59-bedded psychiatric hospital in West Sussex.
Results There was an improvement in monitoring rates for most audit standards. The greatest improvement was seen in measurement of random plasma glucose and cholesterol levels. Rates improved irrespective of the risk of metabolic dysfunction. However, prolactin measurement remained static and the ECG recording deteriorated.
Clinical implications There appears to be a growing awareness of the need to screen for metabolic dysfunction among patients prescribed regular antipsychotic medication. A high-visibility prompt and educational programme helps to increase monitoring rates. However, more needs to be done to improve the mortality and morbidity rates among this patient subpopulation.
antipsychotic medication; metabolic dysfunction; monitoring
The present study was conducted primarily to determine the occurrence of polypharmacy in patients with schizophrenia on risperidone. The secondary aim was to ascertain the incidence of inappropriate prescribing with anticholinergics. A retrospective review of the medical records of all patients who were being followed up at the out-patient clinic of a tertiary-care hospital in Malaysia was conducted. Only patients who were being prescribed risperidone between 1 June 2008 and 31 December 2008 were included in the study. Demographic data such as patient’s age, gender and race were obtained from the patient’s medical records. In total, 113 patients met the selection criteria. Polypharmacy was found to occur in 34 patients (30.09%), with the majority (76.47%) being on two antipsychotics. In total, 27 patients (34.18%) on monotherapy with risperidone were prescribed an anticholinergic on scheduled dosing, while 19 patients (24.05%) were prescribed it on an as-needed basis. Of the patients on polypharmacy, 26 (76.47%) were on scheduled dosing of anticholinergics, while three (8.82%) were taking the medication on an as-needed basis. Polypharmacy should be avoided, and the use of anticholinergics should be closely reviewed. By adopting more efficient prescribing practices, costs can be reduced and financial resources can instead be channelled towards more beneficial areas for the patients.
anticholinergic; antipsychotic; polypharmacy; risperidone; schizophrenia
Background and objectives The purpose of this paper is to describe the use of resident performance on an observed structured clinical examination (OSCE) as a tool to refine a mood disorders curriculum, and to disseminate a mood disorders OSCE for use in other residency settings.
Methods A depression-focused OSCE and a direct observation evaluation tool were developed and implemented. A total of 24 first-year family medicine residents (PGY1) participated in the OSCE, and their performance was used to direct changes in a mood disorders curriculum.
Results Residents performed well on general interview behaviours, and 67% were able to uncover depression in a patient presenting with headaches. Less than 50% of the residents asked about suicidal ideation and recreational drug use. Curriculum was added that addressed the latter deficiencies.
Conclusions Tracking of resident performance on specific behaviours during OSCE sessions can be used for curriculum evaluation purposes. The mood disorders curriculum in additional family medicine residency programmes can now be evaluated using our depression-focused OSCE and Clinical Performance Checklist.
depression; OSCE; residency education
Aims This study aimed to examine the effectiveness of a primary care adult mental health service operating within a stepped care model of service delivery.
Methods Supervised by a principal psychologist manager, psychology graduate practitioners provided one-to-one brief cognitive behavioural therapy (CBT) to service users. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was used to assess service user treatment outcomes. Satisfaction questionnaires were administered to service users and referring general practitioners (GPs).
Results A total of 43 individuals attended for an initial appointment, of whom 19 (44.2%) completed brief CBT treatment. Of the 13 service users who were in the clinical range pre-treatment, 11 (84.6%) achieved clinical and reliably significant improvement. Of the six service users who were in the non-clinical range pre-treatment, three (50%) achieved reliably significant improvement. Both service users and GPs indicated high levels of satisfaction with the service, although service accessibility was highlighted as needing improvement.
Conclusion The service was effective in treating mild to moderate mental health problems in primary care. Stricter adherence to a stepped care model through the provision of low-intensity, high-throughput interventions would be desirable for future service provision.
brief CBT; service evaluation; stepped care model
Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcohol problems.
Methods An educational intervention was developed in partnership with mental health and primary care staff in Russia, to develop mental health skills using established, evidence-based methods. After a preliminary demonstration of teaching methods to be employed, a 5-day full-time teaching course was offered to trainers of general practitioners and feldshers.
Results The findings are presented by providing details of improvements that occurred over a 3-month period in four areas, namely depression in primary care, somatic presentations of distress, dealing with suicidal patients, and alcohol problems. We present preliminary data on how the training has generalised since our visits to Archangelsk.
Conclusions Teachers who are used to teaching by didactic lectures can be taught the value of short introductory talks that invite discussion, and mental health skills can be taught using role play. The content of such training should be driven by perceived local needs, and developed in conjunction with local leaders and teachers within primary care services. Further research will be needed to establish the impact on clinical outcomes.
education; family practice; mental health
Background Increasing morbidity and mortality associated with HIV/AIDS may be attributable to the lifestyle of individuals. Appropriate sexual behaviour and lifestyle modification may be helpful strategies for prevention and control of HIV/AIDS in many countries.
Aim The study was designed to assess the impact of attitudes and sexual behaviour on control of HIV/AIDS among unmarried people living with HIV/AIDS in Uyo, a community in the Niger Delta region of Nigeria.
Method A total of 365 unmarried individuals living with HIV/AIDS were assessed at the HIV clinic of the University of Uyo Teaching Hospital. Attitudes and sexual behaviour were evaluated using the Attitude and Sexual Behaviour Questionnaire adapted from previous studies.
Results Of the 365 individuals living with HIV/AIDS, 142 (38.9%) were male and 223 (61.1%) were female. The majority of the subjects were below 50 years of age. The mean ages (± SD) of men and women were 36.8 ± 3.9 and 29.2 ± 1.7 years, respectively. Sexual attitudes and behaviours were variable. There was no change in the partner's reaction to sex for 28.9% of men and 27.8% of women, abstinence in 7.7% of men and 8.1% of women, and breakdown of the relationship with the partner for 4.9% of men and 7.2% of women. More women than men agreed to undergo testing after their partners had tested positive for HIV. Sexual activity was higher in women than men, with 4.9% of men and 10.3% of women reporting daily sexual intercourse, 16.2% of men and 15.7% of women reporting weekly intercourse, and occasional sexual intercourse being reported by 44.4% of both men and women. After testing positive, 58.4% of male partners and 56.9% of female partners were persuaded to use condoms during sexual intercourse.
Conclusion This study has demonstrated unhealthy attitudes and sexual behaviour among individuals living with HIV/AIDS in the Niger Delta region of Nigeria. This can potentially limit efforts and investment in controlling HIV/AIDS in this region. Therefore there is a need to initiate concrete policies and programmes that would encourage people living with HIV/AIDS in the Niger Delta region to adopt a healthy lifestyle.
behaviour; HIV/AIDS; Nigeria; sexual attitudes; unmarried people
Background Annual health checks are recommended for people with severe mental illness, as they are at high risk of cardiovascular disease. We trained practice nurses from six primary care centres in Northampton, in the UK, how to deliver health checks for this population.
Aims The purpose of this study was to examine patients' views about the physical health check delivered by a nurse trained in the Northampton Physical Health and Wellbeing (PhyHWell) project.
Method We interviewed five patients from three primary care centres using a topic guide.
Results From a total of 29 patients who were invited, five attended. They had a good understanding of the importance of a healthy diet and taking regular exercise, but did not appear to be aware of the risk of cardiovascular disease. Being treated consistently by the same healthcare professional and/or by a nurse was cited as a helpful factor in managing their physical health. Most of the patients were glad to be invited for a health check and thought that it was worthwhile. They would have liked more information about blood tests and medication. All of the patients reported that they had started to make changes to their lifestyle since the health check.
Recommendations Training for practice nurses to provide physical health checks for people with severe mental illness should emphasise the patients' views of what will make them effective.
health check; patients; physical health; primary care; severe mental illness
Background Consanguinity has been suggested as a risk factor for the development of schizophrenia in offspring in some Middle Eastern countries.
Aim The purpose of this study was to review the frequency, pattern of parental consanguinity, and family history of schizophrenia among schizophrenia patients in Qatar, and to determine their impact on the associated risk factors.
Design This is a cross-sectional study which was conducted between January 2009 and December 2010, in the setting of primary health care (PHC) centres of the Supreme Council of Health, State of Qatar.
Subjects A total of 1491 patients aged 18–55 years were approached, of whom 1184 individuals agreed to participate in the study, giving a response rate of 79.4%.
Methods The study was based on face-to-face interviews using a specially designed questionnaire that covered sociodemographic characteristics and genetic and other biological factors (e.g. obstetric complications), and a diagnostic screening questionnaire which consisted of six questions about the symptoms of schizophrenia. The diagnostic screening questionnaire was reviewed and used to calculate the final score, which determined a provisional diagnosis. The psychiatrists discussed the psychiatric diagnosis and confirmed it using DSM-IV criteria. The degree of consanguinity between the patient's parents was recorded. Consanguinity was evaluated based on the coefficient of inbreeding (F), which is the probability of homozygosity.
Results More than half of the schizophrenia patients were female (57.1%) and over 45 years of age (62.5%). A family history of schizophrenia was significantly more common in parents of schizophrenia patients than in the Arab population without schizophrenia (24.6% vs. 17.1%; P = 0.038). Parental consanguinity was elevated among the patients with schizophrenia (41.3%) with a higher mean coefficient of inbreeding (0.04356 ± 0.028) than in non-schizophrenic subjects (28.7%) with a lower mean coefficient of inbreeding (0.0298 ± 0.035). Schizophrenia diagnoses were more frequent among the offspring of consanguineous parents than among the offspring of non-consanguineous parents.
Conclusion The substantial risk observed in the present study reveals that consanguinity is an important risk factor for schizophrenia in Qatar. In addition, the study confirms that the higher familial risks provide strong genetic epidemiological evidence for the overall heritable effects in the aetiology of schizophrenia.
birth complication; consanguinity; genetic disorders; inbreeding; obstetric complication; schizophrenia
Parents have a critical role in adolescent health. The association of adolescents' perceptions of family relationships with adolescent health was investigated using a sample of 67 female adolescents who participated in eight focus group discussions, utilising a purposeful sampling method. All tape-recorded data were fully transcribed and content analysis was performed. Three themes were identified, namely emotional support, responsible parents and well-informed parents. With regard to some of the challenges in Iranian adolescents' relationships with their parents, it is necessary to educate parents to be alert to their role in adolescent health.
adolescent health; content analysis; family
Objective We assessed the feasibility and acceptability to patients of a telephone-supported self-care intervention for depression among adults aged 40 years or over with one of six targeted chronic physical illnesses and comorbid depressive symptoms in family practice settings.
Methods An open, uncontrolled trial (feasibility study) was conducted among patients treated in Montreal family practices. Eligible patients were aged 40 years or over, had one or more of the targeted chronic physical illnesses for at least 6 months (arthritis, hypertension, diabetes, heart disease, asthma and chronic obstructive pulmonary disease) and were evaluated as having at least mild depressive symptoms (a score of ≥ 5 on the 9-item Patient Health Questionnaire, PHQ-9). Participants received a package of six self-care tools (information booklet, video, Internet programme, action plan, workbook and mood-monitoring tool) with telephone support by a lay coach for up to 6 months.
Results In total, 63 eligible patients provided written consent and completed the baseline interview; 57 (90%) and 55 (87%) patients completed 2-month and 6-month follow-up interviews, respectively. The mean number of telephone calls made by coaches to participants was 10.5 (SD 4.0), and the average length of these calls was 10.6 minutes. At the 6-month follow-up, 83.6% of the participants reported that one or more of the tools were helpful. Clinically significant improvements were seen in depressive symptoms (as assessed by the PHQ-9) at 6 months, with an effect size of 0.88 (95% CI, 0.55, 1.14).
Conclusion A telephone-supported self-care intervention for depression was feasible, was acceptable to patients, and was associated with a significant 6-month improvement in depressive symptoms. A randomised trial of this intervention is justified.
comorbidity; depression; feasibility; primary care; self-management
Introduction Maternal depressive symptoms increase the risk of poor maternal and child health outcomes, and are a primary barrier to health behaviour change. Social cognitive theory can guide our understanding of risk factors that may have an impact on maternal depressive symptoms. The aim of this paper was to understand the correlates of maternal depressive symptoms among low-income African American smokers completing a 16-week intervention trial to reduce young children's second-hand smoke exposure (SHSe).
Methods This study presents a secondary analysis of depression symptoms among 227 maternal smokers completing the SHSe-reduction trial. The end-of-treatment Center of Epidemiologic Studies Depression Scale (CES-D) score was used to assess depressive symptoms (dichotomised as 0 = score of < 16 and 1 = score of ≥ 16). Multivariate logistic regression analysis was used to test the one-way hypothesis that odds of significant depressive symptoms would be associated with greater total number of household smokers, greater number of paediatric sick visits, greater daily exposure of child to cigarette smoke by their mother, greater life-event stress, and lower social support, marital status, employment status and level of educational attainment.
Results Number of household smokers (OR = 1.57, P = 0.049), social support (OR = 0.88, P < 0.001) and life-event stress (OR = 1.04, P = 0.001) predicted significant maternal depressive symptoms; all other variables were not significant predictors in the model.
Conclusion Number of household smokers is a novel risk factor for understanding significant maternal depressive symptoms in the context of a childhood SHSe-reduction trial. Improving our understanding of the household-level social milieu in the context of SHSe-reduction interventions will assist in reducing the risk of maternal depressive symptoms.
household smokers; maternal depressive symptoms; social cognitive theory
Objective To assess the frequency and predictors of regular monitoring of metabolic parameters as recommended by the American Diabetes Association (ADA)/American Psychiatric Association (APA) guidelines in adolescents receiving antipsychotics compared with an untreated comparison group in a primary care setting.
Method A retrospective cohort study was conducted using an electronic medical record database in the USA from January 2004 to July 2009. The exposure group consisted of adolescents with a first prescription for second-generation antipsychotics (SGAs). The comparison group, without antipsychotics, was matched (3:1) to the exposed. Baseline and follow-up metabolic measurements were assessed and patients were categorised as being regularly monitored based on recommendations by the ADA/APA guidelines. Multivariate logistic regression was conducted to assess the predictors of regular monitoring, adjusting for demographic characteristics, baseline medications and medical conditions.
Results The frequency of regular monitoring of body mass index (BMI), blood pressure, total cholesterol and fasting blood glucose, as recommended by ADA/APA guidelines among antipsychotic users (25, 55, 2.4 and 1.7%) was low but significantly higher compared with the matched comparison group (9.5, 37.4, 0.8 and 0.7%, respectively) (P < 0.05). Overall, antipsychotic treatment was associated with 1.5- to 4.26-fold increase in the likelihood of metabolic monitoring compared with the comparison group (P < 0.05). Other predictors included oral antidiabetic use for BMI monitoring and dyslipidaemia for blood pressure, total cholesterol and fasting blood glucose.
Conclusion The majority of adolescents on antipsychotics were under-monitored for BMI, lipids and glucose levels. Antipsychotic users with pre-existing and newly diagnosed metabolic conditions were more likely to be regularly monitored for metabolic parameters.
adolescents; antipsychotics; guidelines; metabolic monitoring; primary care
Background There is evidence that the National Institute for Health and Clinical Excellence (NICE) guidelines for mental health disorders are used to varying degrees in primary care. A lack of access to cognitive–behavioural therapy (CBT) has been found to be a barrier to their implementation. The Improving Access to Psychological Therapies (IAPT) initiative was created in 2007 to increase the availability of NICE-recommended psychological treatments for depression and anxiety disorders within the National Health Service in England.
Aim This study aims to investigate whether general practitioners (GPs) who have access to IAPT services and use NICE guidelines are more likely to use NICE concordant treatments for depression than those who do not. Depression was chosen as it is the most common mental health problem facing primary care physicians.
Method Questionnaires were sent to 830 GPs in southeast England and six GPs were interviewed. The response rate to the questionnaires was 27% (n = 222).
Results Ninety-five per cent of GPs were aware of the NICE guidelines for depression, and 76% had read them. Concordance with the guidelines was significantly higher when GPs had access to a local IAPT service or had read the NICE guidelines.
Conclusions The interviews revealed favourable views to IAPT services when used, although access to treatments was still a common barrier to the implementation of the NICE guidelines for depression.
clinical guidelines; depression; evidence-based treatments
Background The mental health functioning of military spouses and intimate partners prior to the combat deployments of their loved ones is poorly studied.
Aims Whereas service members and veterans often receive healthcare directly from the military or the Department of Veterans Affairs, family members may be more likely to present in family care settings. An understanding of mental health problems commonly occurring in this population is therefore important.
Method National Guard soldiers and their spouses or cohabitating partners (n = 223 couples) were surveyed about mental health symptoms, social functioning and mental health service utilisation one to two months prior to a combat deployment to Afghanistan.
Results Screening rates for partner post-traumatic stress disorder, depression, alcohol problems and social impairment were 2.4, 15.3, 3.7 and 10.7%, respectively, and were significantly higher for partners than soldiers with regards to depression and social impairment. The majority of partners screening positive for psychiatric distress did not report utilising mental health services or military support services (i.e. family readiness groups). Clinical implications are discussed.
combat deployment; deployment cycle; depression; family well-being; PTSD
Kabuki syndrome (KS) is a rare genetic disorder first diagnosed in 1981. Unknown by most primary care physicians and clinicians in the mental health fields, children with KS present with unique facial characteristics, mental retardation, health problems and socio-emotional delays that are often mistaken for other diagnostic problems. Literature detailing the psychological and psychosocial features of this disorder is scant, and psychotherapeutic approaches have not been described. In this article, we present a case description and treatment of a child with KS and her family. A brief review of KS is then provided, highlighting its signs and symptoms. Factors related to differential diagnoses are identified to aid primary care and mental health clinicians in better understanding this unique syndrome. Interventions with similar populations are discussed from which a psychological approach to KS is suggested. Finally, implications for primary care physicians are described and suggestions for further research indicated.
differential diagnosis; Kabuki syndrome; psychosocial treatment
Background Child abuse survivors have an increased risk of developing various mental illnesses in adulthood, which may lead survivors to access primary healthcare services, in particular primary care mental health services.
Aim To determine the frequency with which different primary care mental health practitioners encounter child abuse survivors in their practice and differences in their views about routine screening, level of importance, confidence and comfort in screening and supporting survivors, a cross-sectional study was conducted with 186 practitioners.
Method The sample consisted of general practitioners (13.9%), psychologists (67.9%) and other professions such as psychiatrists, social workers, counsellors, psychotherapists, mental health nurses and other specific mental health practitioners (18.2%).
Results Over 91% of practitioners reported that child abuse was a healthcare issue and was a problem for women in their practice. However, only 51.4% believed that women should be routinely screened for child abuse experiences. Significant differences among practitioner groups were found in aspects of screening and responding to survivors. General practitioners were significantly less likely to screen routinely and reported lower levels of confidence and comfort in conducting screening of survivors when compared with psychologists and other practitioners. The majority of practitioners saw it as psychologists' role to routinely screen; however, 57–82% of practitioners within each group reported that they would benefit from further training in areas relating to asking about and supporting survivors.
Conclusion Findings highlighted further education as a potential area of need to enhance the knowledge and capacity of different practitioner groups in responding to women survivors of child abuse.
child abuse survivors; primary care practitioners; screening
Background Mindfulness-based cognitive therapy (MBCT) is an intervention developed for the prevention of recurrent depression which is now being applied to widening numbers of clinical populations. Despite evidence for its effectiveness in preventing relapse in depression, less is known about its efficacy within routine clinical practice for groups of patients with more varied mental health problems, despite this being a potentially promising context for its application.
Aims This pilot study aimed to investigate whether MBCT would be feasible and effective when delivered in a primary care context for patients who are vulnerable to recurrent depression and anxiety.
Results Attrition from the programme was low and both attendance and engagement with home practices (during and after the intervention) were comparable with or higher than those observed in the existing literature. Improvements in self-reported depression, anxiety, rumination, self-compassion and well-being were evident over the 8-week programme and at 6-month post intervention follow-up.
Conclusions Despite limitations in terms of sample size and the absence of a control group, the results demonstrate that the promising research results of MBCT for depression are transferable from a research to a practice setting, and demonstrate that it may be an effective and feasible intervention when delivered in a primary care setting for a range of mental health problems.
depression and anxiety; MBCT; primary care
Background General practitioners (GPs) often see patients presenting with mental health problems, but their training regarding mental health treatment varies. GPs' communication skills are of particular importance in these consultations, and communication skills training of GPs has been found to improve patients' mental health. To tailor a communication skills training by basing it on GPs' learning needs and self-efficacy, thereby maximising learning, we conducted a questionnaire study.
Objective To measure GPs' self-perceived needs regarding communication with and treatment of mental health patients.
Methods GPs in training for specialist general practice were given a questionnaire on communication and mental health in general practice. The questionnaire measured prevalence, referring practices, self-efficacy and self-perceived learning need regarding mental health treatment and communication skills, as well as interest in attending training.
Results A majority of GPs in our sample was interested in training on communication skills and mental health treatment. However, they reported moderate learning needs and high confidence on the different measures. GPs reported highest learning needs regarding specific communication skills and treatment of the most common mental health problems. At the same time, they reported highest self-efficacy in treating the same disorders. They also reported high confidence in communication skills.
Conclusion Despite being confident, GPs in this sample recognise the need for specific skills in consultations with patients with mental health problems, but may underestimate the importance of general communication skills. These results are informative when designing training for GPs in communication and mental health.
communication; general practice; mental health