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The Literature Collection contains over 10,000 references for published and grey literature on the integration of behavioral health and primary care. Learn More
Use the Search feature below to find references for your terms across the entire Literature Collection, or limit your searches by Authors, Keywords, or Titles and by Year, Type, or Topic. View your search results as displayed, or use the options to: Show more references per page; Sort references by Title or Date; and Refine your search criteria. Expand an individual reference to View Details. Full-text access to the literature may be available through a link to PubMed, a DOI, or a URL. References may also be exported for use in bibliographic software (e.g., EndNote, RefWorks, Zotero).
883 Results
641
Promoting mental health in older people admitted to hospitals
Type: Journal Article
Year: 2011
Publication Place: England
Abstract: Mental health problems are common in older people admitted to general hospitals. With an increasing ageing population, admissions will rise and nurses will be expected to manage patients' co-existing mental health problems as well as physical problems. This article explores potential strategies for the management of patients with depression, delirium and dementia. The emphasis is on improving quality of care for this group of vulnerable patients.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Promoting mental health in older people admitted to hospitals
642
Promoting psychiatrist-pediatrician collaborations on postnatal depression prevention
Type: Journal Article
Year: 2019
Publication Place: France
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Promoting psychiatrist-pediatrician collaborations on postnatal depression prevention
643
Promoting psychiatrist-pediatrician collaborations on postnatal depression prevention
Type: Journal Article
Year: 2019
Publication Place: France
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Promoting psychiatrist-pediatrician collaborations on postnatal depression prevention
644
Provider practices in the primary care behavioral health (PCBH) model: an initial examination in the Veterans Health Administration and United States Air Force
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: The goals of this study were to identify characteristics of both behavioral health providers (BHPs) and the patients seen in a primary care behavioral health (PCBH) model of service delivery using prospective data obtained from BHPs. A secondary objective was to explore similarities and differences between these variables within the Veterans Health Administration (VHA) and United States Air Force (USAF) primary care clinics. A total of 159 VHA and 23 USAF BHPs, representing almost every state in the United States, completed the study, yielding data from 403 patient appointments. BHPs completed a web-based questionnaire that assessed BHP and setting characteristics, and a separate questionnaire after each patient seen on one day of clinical service. Data demonstrated that there are many similarities between the VHA and USAF BHPs and practices. Both systems tend to use well-trained psychologists as BHPs, had systems that support the BHP being in close proximity to the primary care providers, and have seamless operational elements (i.e., shared record, one waiting room, same-day appointments, and administrative support for BHPs). Comorbid anxiety and depression was the most common presenting problem in both systems, but overall rates were higher in VHA clinics, and patients were significantly more likely to meet diagnostic criteria for mental health conditions. This study provides the first systematic, prospective examination of BHPs and practices within a PCBH model of service delivery in two large health systems with well over 5 years of experience with behavioral health integration. Many elements of the PCBH model were implemented in a manner consistent with the model, although some variability exists within both settings. These data can help guide future implementation and training efforts.
Topic(s):
General Literature
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645
Psychiatric Case Review and Treatment Intensification in Collaborative Care Management for Depression in Primary Care
Type: Journal Article
Year: 2018
Abstract: OBJECTIVE: This study examined whether psychiatric case review was associated with depression medication modification in a large implementation program of collaborative care for depression in safety-net primary care clinics. METHODS: Registry data were examined from an implementation of the collaborative care model in Washington State. A total of 14,960 adults from 178 primary care clinics who initiated care between January 1, 2008, and September 30, 2014, and who had a baseline Patient Health Questionnaire-9 (PHQ-9) score of 10 or higher were included. Rates of psychiatric case reviews and receipt of new depression medications were extracted from the registry for all patients and for a subset of patients who did not improve by eight weeks of treatment (did not achieve a PHQ-9 score of less than 10 or a reduction in PHQ-9 score of 50% or more, compared with baseline). RESULTS: One-half of patients received a new depression medication. Psychiatric case review in any given month was associated with a doubling of the probability of receiving a new medication in the following month. Among patients who did not improve by eight weeks of treatment, a psychiatric case review during weeks 8-12 was associated with a higher rate of receipt of new medications during weeks 8-16 or weeks 8-20. CONCLUSIONS: In a collaborative care program, psychiatric case review was associated with higher rates of subsequent receipt of a new depression medication. This finding supports the importance of psychiatric case review in reducing clinical inertia in collaborative care treatment of depression.
Topic(s):
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View the DOI record for Psychiatric Case Review and Treatment Intensification in Collaborative Care Management for Depression in Primary Care
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View the PubMed citation for Psychiatric Case Review and Treatment Intensification in Collaborative Care Management for Depression in Primary Care646
Psychiatric disorders in primary care
Type: Journal Article
Year: 2014
Topic(s):
General Literature
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View the DOI record for Psychiatric disorders in primary care
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View the PubMed citation for Psychiatric disorders in primary care647
Psychiatrists' and Primary Care Physicians' Beliefs About Overtreatment of Depression and Anxiety
Type: Journal Article
Year: 2015
Abstract: Critics say that physicians overdiagnose and overtreat depression and anxiety. We surveyed 1504 primary care physicians (PCPs) and 512 psychiatrists, measuring beliefs about overtreatment of depression and anxiety and predictions of whether persons would benefit from taking medication, investing in relationships, and investing in spiritual life. A total of 63% of PCPs and 64% of psychiatrists responded. Most agreed that physicians too often treat normal sadness as a medical illness (67% of PCPs and 62% of psychiatrists) and too often treat normal worry and stress as a medical illness (59% of PCPs, 55% of psychiatrists). Physicians who agreed were less likely to believe that depressed or anxious people would benefit "a lot" from taking an antidepressant (36% vs. 58% of PCPs) or antianxiety medication (25% vs. 42% of PCPs, 42% vs. 57% of psychiatrists). Most PCPs and psychiatrists believe that physicians too often treat normal sadness and worry as a medical illness.
Topic(s):
General Literature
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View the DOI record for Psychiatrists' and Primary Care Physicians' Beliefs About Overtreatment of Depression and Anxiety
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View the PubMed citation for Psychiatrists' and Primary Care Physicians' Beliefs About Overtreatment of Depression and Anxiety649
Psychiatry in primary care using the three-stage assessment
Type: Journal Article
Year: 2014
Publication Place: South Africa
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Psychiatry in primary care using the three-stage assessment
650
Psychiatry residents' confidence in integrated care skills on a collaborative care rotation at a safety net health care system
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
General Literature
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651
Psychiatry's integration with medicine: the role of DSM-5
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Mental disorders represent a significant global burden whose effects are exacerbated by gaps in diagnosis and service provision. A substantial number of individuals seek services not through specialty psychiatric clinics but through primary care. Thus, the interface between psychiatry and the rest of medicine represents an appropriate area of focus in which to improve the detection and treatment of mental disorders. Development of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) can play a key role in this process. DSM-5 is expected to include specific revisions in diagnostic criteria, chapter organization, text structure, and classification approach that are designed to improve use of DSM by nonpsychiatrist physicians. Furthermore, revisions to DSM-5 will inform development of the primary care version of DSM-5. The goal is to publish a manual that enhances clinical utility in a manner that is concise and more amenable to use in primary care.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Psychiatry's integration with medicine: the role of DSM-5
652
Psychological and social problems in primary care patients - general practitioners' assessment and classification
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: OBJECTIVE: To estimate the frequency of psychological and social classification codes employed by general practitioners (GPs) and to explore the extent to which GPs ascribed health problems to biomedical, psychological, or social factors. DESIGN: A cross-sectional survey based on questionnaire data from GPs. Setting. Danish primary care. SUBJECTS: 387 GPs and their face-to-face contacts with 5543 patients. MAIN OUTCOME MEASURES: GPs registered consecutive patients on registration forms including reason for encounter, diagnostic classification of main problem, and a GP assessment of biomedical, psychological, and social factors' influence on the contact. RESULTS: The GP-stated reasons for encounter largely overlapped with their classification of the managed problem. Using the International Classification of Primary Care (ICPC-2-R), GPs classified 600 (11%) patients with psychological problems and 30 (0.5%) with social problems. Both codes for problems/complaints and specific disorders were used as the GP's diagnostic classification of the main problem. Two problems (depression and acute stress reaction/adjustment disorder) accounted for 51% of all psychological classifications made. GPs generally emphasized biomedical aspects of the contacts. Psychological aspects were given greater importance in follow-up consultations than in first-episode consultations, whereas social factors were rarely seen as essential to the consultation. CONCLUSION: Psychological problems are frequently seen and managed in primary care and most are classified within a few diagnostic categories. Social matters are rarely considered or classified.
Topic(s):
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View the DOI record for Psychological and social problems in primary care patients - general practitioners' assessment and classification
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View the PubMed citation for Psychological and social problems in primary care patients - general practitioners' assessment and classification653
Psychological impact of family history risk assessment in primary care: a mixed methods study
Type: Journal Article
Year: 2014
Abstract: BACKGROUND: Routine family history risk assessment for chronic diseases could enable primary care practitioners to efficiently identify at-risk patients and promote preventive management strategies. OBJECTIVES: To investigate patients' understanding and responses to family history risk assessment in primary care. METHOD: A mixed methods study set in 10 Eastern England general practices. Participants in a family history questionnaire validation study were triaged into population or increased risk for four chronic diseases (type 2 diabetes, cardiovascular disease, breast cancer, colorectal cancer). Questionnaires completed immediately prior to the family history consultation (baseline) and 4 weeks later (follow-up) assessed the psychological impact, including State-Trait Anxiety Inventory scores. Semi-structured interviews explored the meaning participants gave to their personal familial disease risk. RESULTS: Four hundred and fifty-three participants completed both baseline and follow-up questionnaires and 30 were interviewed. At follow-up, there was no increase in anxiety among either group, or differences between the groups [difference in mean change 0.02, 95% confidence interval -2.04, 2.08, P = 0.98]. There were no significant changes over time in self-rated health in either group. At follow-up, participants at increased risk (n = 153) were more likely to have recent changes to behaviour and they had stronger intentions to make changes to diet (P = 0.001), physical activity (P = 0.006) and to seek further information in the future than those at population risk (n = 300; P < 0.001). Using qualitative analysis, five themes were developed representing ways in which participants gave meaning to familial disease risk ('Being reassured', 'Controlling risk', 'Dealing with it later', 'Beyond my control', 'Disbelieving the risk'). The meanings they attributed to increased risk appeared to shape their intention to undertake behaviour change. CONCLUSION: Routine assessment for familial risk of chronic diseases may be undertaken in primary care without causing anxiety or reducing self-rated health. Patient responses to family history risk assessment may inform promotion of preventive management strategies.
Topic(s):
General Literature
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View the DOI record for Psychological impact of family history risk assessment in primary care: a mixed methods study
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View the PubMed citation for Psychological impact of family history risk assessment in primary care: a mixed methods study654
Psychological interventions for anxiety in adult primary care patients: A review and recommendations for future research
Type: Journal Article
Year: 2018
Publication Place: Netherlands
Abstract: Anxiety symptoms are prevalent in primary care, yet treatment rates are low. The integration of behavioral health providers into primary care via the Primary Care Behavioral Health (PCBH) model offers a promising way to improve treatment options by adding a team member with the necessary skillset to deliver evidence-based psychological interventions for anxiety. We conducted a narrative review of psychological interventions for anxiety applied within adult primary care settings (k=44) to update the literature and evaluate the fit of existing interventions with the PCBH model. The majority of studies were randomized controlled trials (RCTs; 70.5%). Most interventions utilized cognitive-behavioral therapy (68.2%) and were delivered individually, face-to-face (52.3%). Overall, 65.9% of interventions (58.6% of RCTs, 91.7% of pre-post) were effective in reducing anxiety symptoms, and 83.3% maintained the gains at follow-up. Although it is encouraging that most interventions significantly reduced anxiety, their longer formats (i.e., number and duration of sessions) and narrow symptom targets make translation into practice difficult. Methodological limitations of the research included homogenous samples, failure to report key procedural details, pre-post designs, and restrictive eligibility criteria. We offer recommendations to guide future research to improve the likelihood of successful translation of anxiety interventions into clinical practice.
Topic(s):
General Literature
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655
Psychological therapies in primary care: a progress report
Type: Journal Article
Year: 2014
Publication Place: England
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Psychological therapies in primary care: a progress report
656
Psychological treatment of anxiety in primary care: a meta-analysis
Type: Journal Article
Year: 2013
Publication Place: England
Abstract: BACKGROUND: Guidelines and mental healthcare models suggest the use of psychological treatment for anxiety disorders in primary care but systematic estimates of the effect sizes in primary care settings are lacking. The aim of this study was to examine the effectiveness of psychological therapies in primary care for anxiety disorders. METHOD: The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Medline, PsycINFO and Pubmed databases were searched in July 2010. Manuscripts describing psychological treatment for anxiety disorders/increased level of anxiety symptoms in primary care were included if the research design was a randomized controlled trial (RCT) and if the psychological treatment was compared with a control group. RESULTS: In total, 1343 abstracts were identified. Of these, 12 manuscripts described an RCT comparing psychological treatment for anxiety with a control group in primary care. The pooled standardized effect size (12 comparisons) for reduced symptoms of anxiety at post-intervention was d = 0.57 [95% confidence interval (CI) 0.29-0.84, p = 0.00, the number needed to treat (NNT) = 3.18]. Heterogeneity was significant among the studies (I 2 = 58.55, Q = 26.54, p < 0.01). The quality of studies was not optimal and missing aspects are summarized. CONCLUSIONS: We found a moderate effect size for the psychological treatment of anxiety disorders in primary care. Several aspects of the treatment are related to effect size. More studies are needed to evaluate the long-term effects given the chronicity and recurrent nature of anxiety.
Topic(s):
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View the DOI record for Psychological treatment of anxiety in primary care: a meta-analysis
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View the PubMed citation for Psychological treatment of anxiety in primary care: a meta-analysis658
Psychological treatments are effective for depression in primary care, study shows
Type: Journal Article
Year: 2015
Publication Place: England
Topic(s):
General Literature
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View the DOI record for Psychological treatments are effective for depression in primary care, study shows
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View the PubMed citation for Psychological treatments are effective for depression in primary care, study shows659
Psychology and primary care: New collaborations for providing effective care for adults with chronic health conditions
Type: Journal Article
Year: 2014
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for Psychology and primary care: New collaborations for providing effective care for adults with chronic health conditions
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View the PubMed citation for Psychology and primary care: New collaborations for providing effective care for adults with chronic health conditions660
Psychometric properties of the primary care behavioral health screen
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: The Primary Care Behavioral Health Screen (PCBHS) is a self-report instrument developed to screen for behavioral health problems in primary care settings. The present paper describes development of the PCBHS and reports findings from item analyses and studies examining the instrument's convergent validity and test-retest reliability. Results suggest the PCBHS is a useful and valid method for screening a variety of behavioral health problems in a busy primary care practice. Recommendations for further research on the PCBHS are provided.
Topic(s):
General Literature
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View the DOI record for Psychometric properties of the primary care behavioral health screen
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View the PubMed citation for Psychometric properties of the primary care behavioral health screen