Percepción de la demanda y necesidades de formación en salud mental de los médicos de atención primaria

Postigo, José Miguel Latorre; Hidalgo, Jesús López-Torres; Rodríguez, Juan Montañés; Delgado, Marta Parra

doi:10.1157/13076608

Cited by 17 publications

(11 citation statements)

References 20 publications

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“…Esta discordancia podría deberse a la estigmatización que todavía rodea a la patología mental 15 , que genera rechazo hacia el reconocimiento de estos diagnósticos por los propios pacientes. Es improbable que las diferencias se deban al sobrediagnóstico en atención primaria, por la complejidad de la detección de estos trastornos 16 . El estudio ESEMed-España 17 detectó que un 8,4% de los españoles había presentado un trastorno mental durante el último año, con mayor prevalencia en las mujeres, y estos resultados son inferiores a los observados en las ENS y mucho menores que en la HCE.…”

Section: Discussionunclassified

Morbilidad y consumo de fármacos. Comparación de resultados entre la Encuesta Nacional de Salud y los registros electrónicos

Aguilar-Palacio¹,

Carrera‐Lasfuentes²,

Poblador‐Plou³

et al. 2014

Gaceta Sanitaria

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Section: Discussionunclassified

Morbilidad y consumo de fármacos. Comparación de resultados entre la Encuesta Nacional de Salud y los registros electrónicos

Aguilar-Palacio¹,

Carrera‐Lasfuentes²,

Poblador‐Plou³

et al. 2014

Gaceta Sanitaria

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“…Several reports have demonstrated that insufficient human resources in Spain can lead to misdiagnosis and malpractice [18,19]; moreover, this deficit of trained staff places increased demands on an already oversaturated health care system. Despite this lack of resources, several Spanish studies have found that CBT group therapy is highly efficacious in treating depression in both the short and long term [57], as well as for other EDs [58].…”

Section: Discussionmentioning

confidence: 99%

“…In Spain, the diagnosis of an ED is usually first made by the GP who must decide, in a very brief consultation (ie, less than 7 minutes), which psychoactive drugs to prescribe (if any) and whether or not the patient needs specialized care [18]. As a result of these time constraints, the most common treatments are pharmacological interventions.…”

Section: Introductionmentioning

confidence: 99%

Transdiagnostic Cognitive Behavioral Therapy Versus Treatment as Usual in Adult Patients With Emotional Disorders in the Primary Care Setting (PsicAP Study): Protocol for a Randomized Controlled Trial

Vindel¹,

Muñoz-Navarro²,

Wood³

et al. 2016

JMIR Res Protoc

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BackgroundDemand for primary care (PC) services in Spain exceeds available resources. Part of this strong demand is due to the high prevalence of emotional disorders (EDs)—anxiety, depression, and somatic symptom disorders—and related comorbidities such as pain or chronic illnesses. EDs are often under- or misdiagnosed by general practitioners (GPs) and, consequently, treatment is frequently inadequate.ObjectiveWe aim to compare the short- and long-term effectiveness of group-delivered transdiagnostic cognitive behavioral therapy (TD-CBT) versus treatment as usual (TAU) in the treatment of EDs in the PC setting in Spain. We also aim to compare the effect of these treatments on disability, quality of life, cognitive-emotional factors, and treatment satisfaction.MethodsHere we present the study design of a two-arm, single-blind, randomized controlled trial (N=1126) to compare TAU to TD-CBT for EDs. TAU will consist primarily of pharmacological treatment and practical advice from the GP while TD-CBT will be administered in seven 90-minute group sessions held over a period ranging from 12 to 14 weeks. Psychological assessments are carried out at baseline (ie, pretreatment); posttreatment; and at 3-, 6-, and 12-month follow-up. The study is conducted in approximately 26 PC centers from the National Health System in Spain.ResultsThis study was initiated in December 2013 and will remain open to new participants until recruitment and follow-up has been completed. We expect all posttreatment evaluations to be completed by December 2017, and follow-up will end in December 2018.ConclusionsWe expect the TD-CBT group to have better results compared to TAU on all posttreatment measures and that this improvement will be maintained during follow-up. This project could serve as a model for use in other areas or services of the National Health System in Spain and even in other countries.ClinicalTrialInternational Standard Randomized Controlled Trial Number (ISRCTN): 58437086; http://www.isrctn.com/ISRCTN58437086 (Archived by WebCite at http://www.webcitation.org/6mbYjQSn3)

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“…In Spain, patients with emotional disorders like PD are assessed by their GP who, after only a brief consultation, must decide whether specialized care is required or not [ 16 ]. To facilitate this decision-making process for the GP, adequate screening tools with good psychometric properties are needed to identify patients who are candidates for referral (positive screening test result) to a specialized service (psychological or psychiatric treatment).…”

Section: Discussionmentioning

confidence: 99%

The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain

et al. 2016

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IntroductionPanic disorder is a common anxiety disorder and is highly prevalent in Spanish primary care centres. The use of validated tools can improve the detection of panic disorder in primary care populations, thus enabling referral for specialized treatment. The aim of this study is to determine the accuracy of the Patient Health Questionnaire-Panic Disorder (PHQ-PD) as a screening and diagnostic tool for panic disorder in Spanish primary care centres.MethodWe compared the psychometric properties of the PHQ-PD to the reference standard, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interview. General practitioners referred 178 patients who completed the entire PHQ test, including the PHQ-PD, to undergo the SCID-I. The sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios of the PHQ-PD were assessed.ResultsThe operating characteristics of the PHQ-PD are moderate. The best cut-off score was 5 (sensitivity .77, specificity .72). Modifications to the questionnaire's algorithms improved test characteristics (sensitivity .77, specificity .72) compared to the original algorithm. The screening question alone yielded the highest sensitivity score (.83).ConclusionAlthough the modified algorithm of the PHQ-PD only yielded moderate results as a diagnostic test for panic disorder, it was better than the original. Using only the first question of the PHQ-PD showed the best psychometric properties (sensitivity). Based on these findings, we suggest the use of the screening questions for screening purposes and the modified algorithm for diagnostic purposes.

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Percepción de la demanda y necesidades de formación en salud mental de los médicos de atención primaria

Cited by 17 publications

References 20 publications

Morbilidad y consumo de fármacos. Comparación de resultados entre la Encuesta Nacional de Salud y los registros electrónicos

Morbilidad y consumo de fármacos. Comparación de resultados entre la Encuesta Nacional de Salud y los registros electrónicos

Transdiagnostic Cognitive Behavioral Therapy Versus Treatment as Usual in Adult Patients With Emotional Disorders in the Primary Care Setting (PsicAP Study): Protocol for a Randomized Controlled Trial

The PHQ-PD as a Screening Tool for Panic Disorder in the Primary Care Setting in Spain

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