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The Literature Collection contains over 11,000 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).
952 Results
862
The presentation, recognition and management of bipolar depression in primary care
Type: Journal Article
Year: 2013
Publication Place: United States
Abstract: Bipolar disorder is a mood disorder characterized by episodes of major depression and mania or hypomania. Most patients experience chronic symptoms of bipolar disorder approximately half of the time, most commonly subsyndromal depressive symptoms or a full depressive episode with concurrent manic symptoms. Consequently, patients with bipolar depression are often misdiagnosed with major depressive disorder. Individual patient characteristics and population screening tools may be helpful in improving recognition of bipolar depression in primary care. Health risk behaviors including tobacco use, sedentary activity level and weight gain are highly prevalent in patients with bipolar disorder, as are the comorbid chronic diseases such as diabetes mellitus and cardiovascular disease. Patients with bipolar illness have about an eight-fold higher risk of suicide and a two-fold increased risk of death from chronic medical illnesses. Recognition of bipolar depression and its associated health risk behaviors and chronic medical problems can lead to the use of appropriate interventions for patients with bipolar disorder, which differ in important ways from the treatments used for major depressive disorder. The above topics are reviewed in detail in this article.
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View the DOI record for The presentation, recognition and management of bipolar depression in primary care
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View the PubMed citation for The presentation, recognition and management of bipolar depression in primary care865
The Prevalence of Emotional and Behavior Problems in Pediatric Primary Care Serving Rural Children
Type: Journal Article
Year: 2011
Abstract: OBJECTIVES: To examine the prevalence of parent-reported emotional and behavior problems in pediatric primary care clinics serving rural Appalachia using methods commensurate with studies of broader samples. METHODS: Parents presenting to pediatric primary care clinics completed a rating scale (Pediatric Symptom Checklist) of psychosocial problems for their child. RESULTS: Approximately 21% of all rating scales were in the clinically significant range. Across all parents, 63% identified the child's physician as their most common source of help. In contrast, mental health professionals had been sought out by only 24% of the sample. CONCLUSIONS: These data replicate previous findings showing high rates of parent-rated psychosocial problems in pediatric primary care. Given the prevalence of these problems in primary care and parents' frequent help seeking in this setting, more research is needed on innovative approaches to integrated care in rural settings.
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View the DOI record for The Prevalence of Emotional and Behavior Problems in Pediatric Primary Care Serving Rural Children
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View the PubMed citation for The Prevalence of Emotional and Behavior Problems in Pediatric Primary Care Serving Rural Children866
The primary care physician and Alzheimer's disease: an international position paper
Type: Journal Article
Year: 2010
Publication Place: France
Abstract: This paper aims to define the role of the primary care physician (PCP) in the management of Alzheimer's disease (AD) and to propose a model for a work plan. The proposals in this position paper stem from a collaborative work of experts involved in the care of AD patients. It combines evidence from a literature review and expert's opinions who met in Paris, France, on July 2009 during the International Association of Geriatrics and Gerontology (IAGG) World Congress. The PCP's intervention appears essential at many levels: detection of the onset of dementia, diagnostic management, treatment and follow-up. The key role of the PCP in the management of AD, as care providers and care planners, is consolidated by the family caregiver's confidence in their skills. In primary care practice the first step is to identify dementia. The group proposes a "case finding" strategy, in target situations in which dementia should be detected to allow, secondarily, a diagnosis of AD, in certain cases. We propose that the PCP identifies 'typical' cases. In typical cases, among older subjects, the diagnosis of "probable AD" can be done by the PCP and then confirm by the specialist. While under-diagnosis of AD exists, so does under-disclosure. Disclosure to patient and family should be done by both specialist and PCP. Then, the PCP has a central role in management of the disease with the general objectives to detect, prevent and treat, when possible, the complications of the disease (falls, malnutrition, behavioural and psychological symptoms of dementia). The PCP needs to give basic information to the caregiver on respite care and home support services in order to prevent crisis situations such as unplanned institutionalisation and "emergency" hospital admission. Finally, therapeutic research must be integrated in the daily practice of PCP. It is a matter of patients' right to benefit from access to innovation and clinical research whatever his age or diseases, while of course fully respecting the rules and protective measures that are in force.
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Reference Links: View the PubMed citation for The primary care physician and Alzheimer's disease: an international position paper
867
The promise of shared decision making in mental health
Type: Journal Article
Year: 2010
Publication Place: United States
Topic(s):
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Reference Links: View the PubMed citation for The promise of shared decision making in mental health
869
The Psychiatric Assessment and Brief Intervention Program: Partnering With Primary Care Providers
Type: Journal Article
Year: 2018
Publication Place: United States
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View the DOI record for The Psychiatric Assessment and Brief Intervention Program: Partnering With Primary Care Providers
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View the PubMed citation for The Psychiatric Assessment and Brief Intervention Program: Partnering With Primary Care Providers870
The relationship of depression and diabetes: Pathophysiological and treatment implications
Type: Journal Article
Year: 2011
Topic(s):
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View the DOI record for The relationship of depression and diabetes: Pathophysiological and treatment implications
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View the PubMed citation for The relationship of depression and diabetes: Pathophysiological and treatment implications872
The role of primary care in service provision for people with severe mental illness in the United kingdom
Type: Journal Article
Year: 2012
Publication Place: United States
Abstract: BACKGROUND: Severe mental illness is a serious and potentially life changing set of conditions. This paper describes and analyses patient characteristics and service usage over one year of a representative cohort of people with a diagnosis of severe mental illness across England, including contacts with primary and secondary care and continuity of care. METHODS AND FINDINGS: Data were collected from primary care patient notes (n = 1150) by trained nurses from 64 practices in England, covering all service contacts from 1(st) April 2008 to 31st March 2009. The estimated national rate of patients seen only in primary care in the period was 31.1% (95% C.I. 27.2% to 35.3%) and the rates of schizophrenia and bipolar disorder were 56.8% (95% C.I. 52.3% to 61.2%) and 37.9% (95% C.I. 33.7% to 42.2%). In total, patients had 7,961 consultations within primary care and 1,993 contacts with mental health services (20% of the total). Unemployed individuals diagnosed more recently were more likely to have contact with secondary care. Of those seen in secondary care, 61% had at most two secondary care contacts in the period. Median annual consultation rates with GPs were lower than have been reported for previous years and were only slightly above the general population. Relational continuity in primary care was poor for 21% of patients (Modified Modified Continuity Index = <0.5), and for almost a third of new referrals to mental health services the primary care record contained no information on the referral outcome. CONCLUSIONS: Primary care is centrally involved in the care of people with serious mental illness, but primary care and cross-boundary continuity is poor for a substantial proportion. Research is needed to determine the impact of poor continuity on patient outcomes, and above all, the impact of new collaborative ways of working at the primary/secondary care interface.
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View the DOI record for The role of primary care in service provision for people with severe mental illness in the United kingdom
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View the PubMed citation for The role of primary care in service provision for people with severe mental illness in the United kingdom873
The role of primary care in the recognition of and response to dementia
Type: Journal Article
Year: 2010
Publication Place: France
Topic(s):
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View the PubMed citation for The role of primary care in the recognition of and response to dementia
Reference Links: View the PubMed citation for The role of primary care in the recognition of and response to dementia
875
The role of psychotherapy in integrated care
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: The current emphasis on integrated psychiatric and medical care for people with mental illnesses raises hopes for more favorable clinical outcomes as well as concerns about the quality of the actual care being delivered. The author writes from the perspective of a long career as a psychiatrist and psychoanalyst in a full service medical building in which communication and, at times, collaboration between mental health and general health providers yielded significant benefits to patients. Psychotherapy played a major role in these favorable outcomes, as did accessibility to general medical services when needed and working relationships between physicians of different specialties. However, conditions in current integrated systems pose seemingly insurmountable obstacles to offering full service psychiatric care. The overwhelming disproportion between the numbers of patients in serious need and the available psychiatric resources creates wrenching clinical dilemmas. The hard-nosed administrative approaches to the challenge appear to leave out the factors of human relationships and the conditions necessary for effective psychotherapy beyond simple triage and ultra-brief supportive therapy in crises. Where it is possible for psychiatrists to work closely with other physicians, certain conditions are necessary to maintain the integrity of the psychotherapeutic relationship and the psychiatrist's psychotherapeutic skills.
Topic(s):
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876
The South West Local Health Integration Network Behavioural Supports Ontario Experience
Type: Journal Article
Year: 2016
Publication Place: Canada
Abstract: Creating a seamless system of care with improved system and patient outcomes is imperative to the estimated 35,000 older adults living with mental health problems and addictions in the South West Local Health Integration Network. Building on existing investments and those offered through the Behavioural Supports Ontario program, strategies to improve system coordination were put in place, cross-sectoral partnerships were fostered, interdisciplinary teams from across the care continuum were linked, and educational opportunities were promoted. This evolving, co-created system has resulted in a decrease in alternate level of care cases among those with behavioural specialized needs and improved client/family perceptions of care. Also, in fiscal year 2014/15, it provided more than 7,000 care providers with learning opportunities.
Topic(s):
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Reference Links: View the PubMed citation for The South West Local Health Integration Network Behavioural Supports Ontario Experience
878
The symptom cluster-based approach to individualize patient-centered treatment for major depression
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: Unipolar major depressive disorder is a common, disabling, and costly disease that is the leading cause of ill health, early death, and suicide in the United States. Primary care doctors, in particular family physicians, are the first responders in this silent epidemic. Although more than a dozen different antidepressants in 7 distinct classes are widely used to treat depression in primary care, there is no evidence that one drug is superior to another. Comparative effectiveness studies have produced mixed results, and no specialty organization has published recommendations on how to choose antidepressants in a rational, evidence-based manner. In this article we present the theory and evidence for an individualized, patient-centered treatment model for major depression designed around a targeted symptom cluster-based approach to antidepressant selection. When using this model for healthy adults with major depressive disorder, the choice of antidepressants should be guided by the presence of 1 of 4 common symptom clusters: anxiety, fatigue, insomnia, and pain. This model was built to foster future research, provide a logical framework for teaching residents how to select antidepressants, and equip primary care doctors with a structured treatment strategy to deliver optimal patient-centered care in the management of a debilitating disease: major depressive disorder.
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View the DOI record for The symptom cluster-based approach to individualize patient-centered treatment for major depression
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View the PubMed citation for The symptom cluster-based approach to individualize patient-centered treatment for major depression880
The tri-optic: Next step for Collaborative Family Health Care
Type: Journal Article
Year: 2015
Publication Place: United States
Topic(s):
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View the DOI record for The tri-optic: Next step for Collaborative Family Health Care
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View the PubMed citation for The tri-optic: Next step for Collaborative Family Health Care