Epidemilogical and clincial use of GMHAT-PC ( Global Mental Health assessment tool- primary care )in cardiac patients

Abstract

BackgroundA computer assisted interview, the GMHAT/PC has been developed to assist General Practitioners and other Health Professionals to make a quick, convenient and comprehensive standardised mental health assessment. It has proved to be a reliable and valid tool in our previous studies involving General Practitioners and Nurses. Little is known about its use in cardiac rehabilitation settings.AimThe study aims to assess the feasibility of using a computer assisted diagnostic interview by nurses for patients attending Cardiac Rehabilitation Clinics and to examine the level of agreement between the GMHAT/PC diagnosis and a Psychiatrist clinical diagnosis. Prevalence of mental illness was also measured.DesignCross sectional validation and feasibility study.MethodsNurses using GMHAT/PC examined consecutive patients presenting to a cardiac rehabilitation centre. A total of 118 patients were assessed by nurses and consultant psychiatrist in cardiac rehabilitation centres. The kappa coefficient (κ), sensitivity, and specificity of the GMHAT/PC diagnosis were analysed as measures of validity. The time taken for the interview as well as feedback from patients and interviewers were indicators of feasibility. Data on prevalence of mental disorders in an outpatient cardiac rehabilitation setting was collected.ResultsThe mean duration of the interview was 14 minutes. Feedback from patients and interviewers indicated good practical feasibility. The agreement between GMHAT/PC interview-based diagnoses and consultant psychiatrists' ICD-10 criteria-based clinical diagnosis was good or excellent (κ = 0.76, sensitivity = 0.73, specificity = 0.90). The prevalence of mental disorders in this group was 22%, predominantly depression. Very few cases were on treatment.ConclusionGMHAT/PC can assist nurses in making accurate mental health assessments and diagnoses in a cardiac rehabilitation setting and is acceptable to cardiac patients. It can successfully be used to gather epidemiological data and help in managing mental health problems in this group of patients.

Development of a novel diagnostic system for a telepsychiatric application: a pilot validation study

“…Ideally, another structured interview could have been used for comparison, as it has been noted that reliability of open-form clinical interviews is comparatively low [ 19 ], though it can be improved by using diagnostic criteria [ 20 ], as is the case in our clinical setting. Other studies have also relied on consultants’ diagnoses in the absence of a structured interview comparison, or even otherwise [ 21 , 22 ]. Finally, at this initial stage only a pre-computerised version of the diagnostic tool could be tested.…”

About the Allocation of Mental Disorders Risk Groups in the Practice of Cardiology Department

“…Для решения проблемы предлагают, к примеру, компьютеризированные программы оцен-ки психического статуса больных [16]. Результаты нашего исследования свидетельствуют о возмож-ности выделения группы риска среди пациентов, поступающих в кардиологическое отделение, уже на этапе поступления в многопрофильный стационар на основе количественного анализа анамнестиче-ских и лабораторных данных.…”

Psychiatric morbidity in medically ill patients by means of the Spanish version of the Global Mental Health Assessment Tool - Primary Care (GMHAT/PC)

“…One study carried out in India used the tool to diagnose psychiatric morbidity in chronic respiratory disorders (13). There have been also studies in other medical settings including cardiac and epileptic patients (14).…”