Enfermedades mentales comunes en atención primaria: dificultades diagnósticas y terapéuticas, y nuevos retos en predicción y prevención. Informe SESPAS 2020

Conejo-Cerón, Sonia; Rodríguez-Bayón, Antonina; Ballesta-Rodríguez, María Isabel; Mendive, Juan Manuel; Moreno-Peral, Patrícia

doi:10.1016/j.gaceta.2020.05.013

Cited by 11 publications

(12 citation statements)

References 37 publications

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“…This is organized in territorially delimited community centres that employ multidisciplinary teams of general practitioners (GPs), nurses, and social workers but few psychologists (though some have been incorporated recently). Since specialized care waiting times are too long, many mental health cases are treated in primary care by GPs, who have consultations of less than 10 min and insufficient training in psychology to handle them [ 6 ]. This leads to misdiagnosis [ 7 – 9 ] and poor treatment (or even non-treatment) [ 6 , 10 ], medication being the principal recourse.…”

Section: Introductionmentioning

confidence: 99%

“…Since specialized care waiting times are too long, many mental health cases are treated in primary care by GPs, who have consultations of less than 10 min and insufficient training in psychology to handle them [ 6 ]. This leads to misdiagnosis [ 7 – 9 ] and poor treatment (or even non-treatment) [ 6 , 10 ], medication being the principal recourse. Spain is the eighth highest consumer of antidepressants of any OECD country, with 77 defined daily doses (DDDs) per 1000 habitants, which is double the OECD average [ 11 ]; and since 2010, anxiolytic and hypnotic use has increased by 200%, reaching in 91 DDDs in 2020 [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol

et al. 2022

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Background Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). Methods A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. Discussion This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. Trial registration ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021)

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol

et al. 2022

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“…There is a large body of evidence on the benefits of PA and PE for people with depression, in prevention [ 16 , 17 ] as a protective factor against depression [ 18 ], as a preventive strategy [ 19 ], effective in primary prevention [ 20 ], and treatment [ 21 , 22 , 23 , 24 , 25 ], and as an adjuvant treatment [ 19 , 26 , 27 ] from severe to moderate depression with an exercise program [ 28 ], where strengthening exercises [ 28 ] could reduce the intake of antidepressants [ 16 , 17 ]. There were two meta-analyses of structured exercise programs that were recently published that conclude that heart rate and muscle strength improvement (based on resistance exercise) are moderators of depression improvement in middle-aged and older adults [ 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Physical Activity and Prevalence of Depression and Antidepressants in the Spanish Population

et al. 2022

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Introduction: Depression is a mental disorder that affects more than 250 million people in the world, limiting their functional capacities. The work of public health policies is aimed at reducing its prevalence as well as its pharmaceutical cost. Physical activity (PA) programs are interventions with a high potential for effectiveness. Objectives: To establish the relationships between physical activity and the prevalence of depression and antidepressant intake in the Spanish population. Design: We performed a correlational study that was based on data from the European Health Survey Spain 2020 with 20,287 participants, aged 18–84 years, living in Spain. Results: Dependency relationships were found between the prevalence of depression, and: the frequency of PA, the number of days of PA per week, and the number of days of muscle strengthening in the population, in both sexes, and in all age groups (p < 0.001). Dependency relationships were found between the three PA variables and the prevalence of taking antidepressants (p < 0.001). An elevated prevalence of depression and antidepressant taking were found in the inactive groups compared to those who performed PA (p < 0.05). Conclusions: There is an inverse relationship between physical activity and the probability of suffering from depression and the intake of antidepressants. Performing PA 3–4 days/week, including 1–2 days of strength work, could be the best proposal to reduce the prevalence of depression in the Spanish population.

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“…Prior evidence suggests that clinicians perceive the emotional distress of their patients, but have difficulties in specifying standardized psychiatric diagnoses. 17,24 Consultations with a recorded diagnosis of a psychological problem take longer, 25 and might require re-assessment of suspected cases to increase accuracy. 26 It seems likely that the diagnoses detected in primary care during the pandemic might account for more severe cases of mental health issues.…”

Section: Discussionmentioning

confidence: 99%

“…15 Primary care services in Spain are the first point of contact with healthcare services for the population, 16 and they carry the major burden of detection, management and treatment of mild mental health problems. 17…”

Section: Settingmentioning

confidence: 99%

The impact of the COVID-19 pandemic on diagnoses of common mental health disorders in adults in Catalonia, Spain

Raventós

Pistillo

Reyes

et al. 2021

Preprint

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Objectives: To investigate how incidence trends of anxiety and depressive disorders have been affected by the COVID-19 pandemic. Design: Population-based cohort study. Setting: Observational cohort study from 2018 to 2021 using the Information System for Research in Primary Care (SIDIAP) database in Catalonia, Spain. Participants: 4,255,847 individuals aged 18 or older in SIDIAP on 1 March, 2018 with no prior history of anxiety and depressive disorders. Primary and secondary outcomes measures: Incidence of anxiety and depressive disorders prior to COVID-19 (March, 2018 to February, 2020), during the COVID-19 lockdown (March to June, 2020) and post-lockdown periods (from July, 2020 to March, 2021) were calculated. Forecasted rates over COVID-19 periods were estimated using negative binomial regression models based on previous data. The percentage reduction was estimated by comparing forecasted versus observed events, overall and by age, sex and socioeconomic status. Results: The incidence rates per 100,000 person-months of anxiety and depressive disorders were 171.0 (95%CI: 170.2-171.8) and 46.6 (46.2-47.0), respectively, during the pre-lockdown period. We observed an increase of 39.7% (95%PI: 26.5 to 53.3) in incident anxiety diagnoses compared to the expected in March, 2020, followed by a reduction of 16.9% (8.6 to 24.5) during the post-lockdown periods. A reduction of incident depressive disorders occurred during the lockdown and post-lockdown periods (46.6% [38.9 to 53.1] and 23.2% [12.0 to 32.7], respectively). Reductions were higher among adults aged 18 to 34 and individuals living in most deprived areas. Conclusions: The COVID-19 pandemic in Catalonia was associated with an initial increase in anxiety disorders diagnosed in primary care, but a reduction in cases as the pandemic continued. Diagnoses of depressive disorders were lower than expected throughout the pandemic.

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Enfermedades mentales comunes en atención primaria: dificultades diagnósticas y terapéuticas, y nuevos retos en predicción y prevención. Informe SESPAS 2020

Cited by 11 publications

References 37 publications

Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol

Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol

Physical Activity and Prevalence of Depression and Antidepressants in the Spanish Population

The impact of the COVID-19 pandemic on diagnoses of common mental health disorders in adults in Catalonia, Spain

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