1,721,242 research outputs found
Identification and management of depression in primary care settings. A meta-review of evidence
No full textAim - The purpose of this review is to summarize the evidence base on the effectiveness of (a) screening for depression in primary care; (b) managing depression in primary care employing specific management strategies; (c) treating primary care depressive patients with antidepressants. Methods - Meta-review of all available reviews of the evidence. Results - Screening alone does not improve the recognition, management and outcome of depression in primary care settings. Management strategies, including (a) training primary care staff, (b) consultation-liaison, (c) collaborative care, (d) replacement/referral are supported by insufficient evidence to provide a definite answer as to the clinical effectiveness of individual models. Robust evidence exists to encourage physicians to prescribe effective doses of antidepressants in patients with moderate to severe depression who seek treatment in primary care settings. Conclusion - Population-level screening campaigns have a negative ratio of costs to benefits. However, at an individual-level of care increasing the ability of primary care physicians in recognising depression remains a relevant factor. Primary care physicians should consider whether depression is mild, moderate or severe. This patient categorisation help develop appropriate management and therapeutic strategies
To which extent mental health services meet the patients’ needs and provide satisfactory care?
No full textIncreasing importance is being given to the views of mental health service users about their care. Central to this debate is the capability of mental health services to meet the needs of patients and provide satisfactory care. A remarkable improvement in the quality of research and a better understanding of the role of service satisfaction and needs for care measurements has been achieved recently. Both measurements can provide highly valuable service-specific information and useful knowledge for service planning and evaluation. It has definitely been proved that the perspectives of staff and users on needs for care do differ, that social needs are more difficult to meet than clinical needs and that needs for care might differ widely in individuals with different disorders. Service satisfaction measurement has been shown to be a sensitive method to detect differences between different approaches, and identify aspects of care, such as involvement of relatives and information provided, likely to be perceived, in the patient's perspective, as unsatisfactory in many mental heath services. A further effort is requested to establish the social, patient and service characteristics that interfere with needs for care and service satisfaction over time. © 2002 Lippincott Williams & Wilkins
Detection and management of mental distress and psychiatric disorders in primary care settings
No full textInformation systems for mental health
No full textThe use of information systems and computer scienceapplications in the health sector is now entrenched andwidespread. In mental health services there are the typicalapplications of information systems concerning administrative,clinical and research issues, as well as innovativeapplications concerning diagnostic procedures, self-help,communication and delivery of psychotherapy
Psychotropic drug epidemiology. The road travelled, the road ahead
No full textPsychotropic drug epidemiology is a discipline developed to study the use and the effects of drugs in large numbers of individuals. It describes how drugs are prescribed and utilized, investigates reasons underlying prescriptions, and monitors outcomes and variables which may affect these outcomes. In this article the main purposes, study designs and limitations of current pharmacoepidemiological approaches are reviewed with the aim of assessing whether this discipline can constitute a permanent link between the experimental world of clinical trials and the real world of everyday prescribing. We support the notion that evidence generated in clinical practice, by means of pharmacoepidemiological studies, should increasingly be used to develop and suggest innovative research hypotheses to be subsequently tested in pragmatic experimental studies. © 2005 Institute of Psychiatry
Long stay and long term patients in an area with a community based system of care. A register follow up study
No full text- …
