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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
121
Behavioral health integration and the risks of reductionism
Type: Journal Article
Year: 2018
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Behavioral health integration and the risks of reductionism
122
Behavioral health interventions being implemented in a VA primary care system
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: The integration of behavioral health and primary care has received much attention in the literature. Behavioral health providers (BHPs) in integrated settings are faced with different treatment constraints than those who work in specialty mental health. The existing literature focuses on what BHPs should do in primary care settings; however, little research exists specifying what BHPs are actually doing. This study provides a glimpse into what types of interventions BHPs are using, and what types of patients they are seeing, in primary care. A chart review was conducted of patients (N = 180) seen by BHPs in five Veterans Affairs primary care clinics. Depression was the most common diagnosis, while less common presenting problems included substance abuse/dependence, psychosis, and bipolar disorder. Common interventions used were medical management, psycho-education, elements of cognitive-behavioral therapy (CBT), and supportive psychotherapy. Future research should examine the efficacy of brief interventions in primary care settings.
Topic(s):
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View the DOI record for Behavioral health interventions being implemented in a VA primary care system
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View the PubMed citation for Behavioral health interventions being implemented in a VA primary care system123
Behavioral health screening and intervention in primary care
Type: Journal Article
Year: 2011
Publication Place: United States
Topic(s):
General Literature
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View the DOI record for Behavioral health screening and intervention in primary care
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View the PubMed citation for Behavioral health screening and intervention in primary care124
Behavioral Health Screening in Pediatric Primary Care: A Pilot Study
Type: Journal Article
Year: 2014
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Behavioral Health Screening in Pediatric Primary Care: A Pilot Study
126
Behaviors of children following a randomized controlled treatment program for their abused mothers
Type: Journal Article
Year: 2005
Topic(s):
General Literature
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View the DOI record for Behaviors of children following a randomized controlled treatment program for their abused mothers
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View the PubMed citation for Behaviors of children following a randomized controlled treatment program for their abused mothers127
Bipolar disorder in general practice: challenges and opportunities
Type: Journal Article
Year: 2010
Publication Place: Australia
Abstract: General practitioners are involved in the continuing care and shared care of patients with chronic mental illness, including bipolar disorder. Psychiatrists are particularly reliant on GPs to monitor and treat comorbidities as well as the psychiatric condition itself. Management of chronic mental illness is compromised by a number of factors, including problems with diagnosis, physical comorbidity, erratic attendance and poor compliance with treatment. Diagnosis of bipolar disorder is often delayed, and differential diagnoses to be considered include unipolar depression, anxiety disorder, drug and alcohol dependence, personality disorder, attention deficit hyperactivity disorder, and general medical and central nervous system diseases. New Medicare items have been introduced under the Better Access to Mental Health Care initiative. However, uptake for patients with chronic psychiatric illness, including bipolar disorder, is low. Patients with bipolar disorder may be prone to a range of comorbid psychological, social and physical problems, and GPs need to be vigilant to detect and manage comorbidity and social problems as part of the overall plan. This includes assistance with certification for sickness and unemployment benefits. GPs may become involved during crises affecting patients and this may pose significant problems for GPs who need to provide ongoing care following patient discharge from hospital. Despite these difficulties, opportunities exist for GPs to play a vital and ongoing role in the management of patients with bipolar disorder.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Bipolar disorder in general practice: challenges and opportunities
128
Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment
Type: Journal Article
Year: 2019
Publication Place: England
Abstract: Objective: To understand primary care patients' and clinicians' experiences with diagnosis and treatment of patients with bipolar disorder in primary care. Methods: We conducted a qualitative study using thematic content analysis of individual interviews with nine primary care clinicians and six patients from Federally Qualified Health Centers to understand their experiences with the diagnosis and treatment of bipolar disorder. Results: Themes of bipolar disorder detection, referral to specialty mental health care and medication treatment emerged from individual interviews with primary care patients and clinicians. Clinicians and patients faced challenges deciding to continue with care in primary care that is easier to access, but less intensive, than specialty care that can be harder to access but at times of higher quality. Conclusions: Potential next steps in research include identifying ways to support primary care clinicians in detection of patients with bipolar disorder, and strategies to support treatment of patients in primary care with easier access to specialty care including consultation in primary care or co-management with specialty care.
Topic(s):
General Literature
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View the DOI record for Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment
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View the PubMed citation for Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment129
Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment
Type: Journal Article
Year: 2019
Publication Place: England
Abstract: Objective: To understand primary care patients' and clinicians' experiences with diagnosis and treatment of patients with bipolar disorder in primary care. Methods: We conducted a qualitative study using thematic content analysis of individual interviews with nine primary care clinicians and six patients from Federally Qualified Health Centers to understand their experiences with the diagnosis and treatment of bipolar disorder. Results: Themes of bipolar disorder detection, referral to specialty mental health care and medication treatment emerged from individual interviews with primary care patients and clinicians. Clinicians and patients faced challenges deciding to continue with care in primary care that is easier to access, but less intensive, than specialty care that can be harder to access but at times of higher quality. Conclusions: Potential next steps in research include identifying ways to support primary care clinicians in detection of patients with bipolar disorder, and strategies to support treatment of patients in primary care with easier access to specialty care including consultation in primary care or co-management with specialty care.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment
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View the PubMed citation for Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment131
Bipolar disorder is common in depressed primary care patients
Type: Journal Article
Year: 2011
Publication Place: United States
Abstract: OBJECTIVE: To examine the prevalence and treatment of typical and subsyndromal bipolar disorder (BD) in depressed primary care patients. METHODS: Patients with a diagnosis of a mood disorder being treated with antidepressants in 2 academic family practice clinics underwent a structured diagnostic interview (Mini International Neuropsychiatric Inventory) for manic and hypomanic symptoms. RESULTS: Of 58 patients evaluated, 19% met full criteria for bipolar I disorder and 8.6% for bipolar II disorder; 31% had subsyndromal BD (ie, persistent elation or irritability accompanied by additional symptoms of hypomania but not enough symptoms to meet full criteria for bipolar I or II disorder). Only 5 patients with BD were receiving mood stabilizers, which had not been instituted in any patient by the primary care physician. CONCLUSIONS: The high prevalence of patients meeting full criteria for BD and the low rate of identification of BD in primary care patients are consistent with estimates using self-administered questionnaires, but the interview revealed a substantial additional population that could be considered to have subsyndromal BD. Because subsyndromal forms of BD are associated with significant impairment and comorbidity as well as progression to frank BD, recognition of both full and subthreshold BD in primary care practice should be improved.
Topic(s):
General Literature
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View the DOI record for Bipolar disorder is common in depressed primary care patients
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View the PubMed citation for Bipolar disorder is common in depressed primary care patients132
Bridging the gap between primary care and mental health
Type: Journal Article
Year: 2011
Publication Place: United States
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Bridging the gap between primary care and mental health
133
Brief CBT for insomnia delivered in primary care to patients endorsing suicidal ideation: a proof-of-concept randomized clinical trial
Type: Journal Article
Year: 2019
Publication Place: England
Topic(s):
General Literature
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134
Brief cognitive behavioral therapy in primary care: a hybrid type 2 patient-randomized effectiveness-implementation design
Type: Journal Article
Year: 2012
Publication Place: England
Abstract: BACKGROUND: Despite the availability of evidence-based psychotherapies for depression and anxiety, they are underused in non-mental health specialty settings such as primary care. Hybrid effectiveness-implementation designs have the potential to evaluate clinical and implementation outcomes of evidence-based psychotherapies to improve their translation into routine clinical care practices. METHODS: This protocol article discusses the study methodology and implementation strategies employed in an ongoing, hybrid, type 2 randomized controlled trial with two primary aims: (1) to determine whether a brief, manualized cognitive behavioral therapy administered by Veterans Affairs Primary Care Mental Health Integration program clinicians is effective in treating depression and anxiety in a sample of medically ill (chronic cardiopulmonary diseases) primary care patients and (2) to examine the acceptability, feasibility, and preliminary outcomes of a focused implementation strategy on improving adoption and fidelity of brief cognitive behavioral therapy at two Primary Care-Mental Health Integration clinics. The study uses a hybrid type 2 effectiveness/implementation design to simultaneously test clinical effectiveness and to collect pilot data on a multifaceted implementation strategy that includes an online training program, audit and feedback of session content, and internal and external facilitation. Additionally, the study engages the participation of an advisory council consisting of stakeholders from Primary Care-Mental Health Integration, as well as regional and national mental health leaders within the Veterans Administration. It targets recruitment of 320 participants randomized to brief cognitive behavioral therapy (n = 200) or usual care (n = 120). Both effectiveness and implementation outcomes are being assessed using mixed methods, including quantitative evaluation (e.g., intent-to-treat analyses across multiple time points) and qualitative methods (e.g., focus interviews and surveys from patients and providers). Patient-effectiveness outcomes include measures of depression, anxiety, and physical health functioning using blinded independent evaluators. Implementation outcomes include patient engagement and adherence and clinician brief cognitive behavioral therapy adoption and fidelity. CONCLUSIONS: Hybrid designs are needed to advance clinical effectiveness and implementation knowledge to improve healthcare practices. The current article describes the rationale and challenges associated with the use of a hybrid design for the study of brief cognitive behavioral therapy in primary care. Although trade-offs exist between scientific control and external validity, hybrid designs are part of an emerging approach that has the potential to rapidly advance both science and practice. TRIAL REGISTRATION: NCT01149772 at http://www.clinicaltrials.gov/ct2/show/NCT01149772.
Topic(s):
General Literature
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136
Bringing together physical and mental health within primary care: a new frontier for integrated care
Type: Journal Article
Year: 2016
Publication Place: England
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Bringing together physical and mental health within primary care: a new frontier for integrated care
137
Building an evidence base for the co-occurrence of chronic disease and psychiatric distress and impairment
Type: Journal Article
Year: 2014
Publication Place: United States
Abstract: INTRODUCTION: Mental disorders and chronic diseases have been reported to independently affect half of the US population. The objective of this study was to evaluate the comorbid nature of these conditions. METHODS: We analyzed data from 39,954 participants from the 2009 California Health Interview Survey who reported both psychological distress and impairment, on the basis of the Kessler 6 and the Sheehan Disability Scale, and 1 or more of 4 chronic diseases (type 2 diabetes, high blood pressure, asthma, heart disease). Weighted and nonweighted multivariable logistic regression were used to investigate the association between psychological distress and impairment and chronic disease, after adjusting for sex, age, race, current smoking, binge drinking in the previous year, moderate physical activity, and body mass index. RESULTS: After controlling for covariates in the model, we found a significant dose-response relationship between reported chronic diseases and psychiatric distress and impairment that ranged from 1.50 for 1 reported chronic disease to 4.68 for 4 reported chronic diseases. CONCLUSION: The growing chronic disease burden should be understood clinically in the context of mental health conditions. Further research is needed to identify ways to integrate mental health and chronic disease prevention in primary care.
Topic(s):
General Literature
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Reference Links:
View the DOI record for Building an evidence base for the co-occurrence of chronic disease and psychiatric distress and impairment
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View the PubMed citation for Building an evidence base for the co-occurrence of chronic disease and psychiatric distress and impairment138
Buprenorphine: new treatment of opioid addiction in primary care
Type: Journal Article
Year: 2011
Publication Place: Canada
Abstract: OBJECTIVE: To review the use of buprenorphine for opioid-addicted patients in primary care. QUALITY OF EVIDENCE: The MEDLINE database was searched for literature on buprenorphine from 1980 to 2009. Controlled trials, meta-analyses, and large observational studies were reviewed. MAIN MESSAGE: Buprenorphine is a partial opioid agonist that relieves opioid withdrawal symptoms and cravings for 24 hours or longer. Buprenorphine has a much lower risk of overdose than methadone and is preferred for patients at high risk of methadone toxicity, those who might need shorter-term maintenance therapy, and those with limited access to methadone treatment. The initial dose should be given only after the patient is in withdrawal. The therapeutic dose range for most patients is 8 to 16 mg daily. It should be dispensed daily by the pharmacist with gradual introduction of take-home doses. Take-home doses should be introduced more slowly for patients at higher risk of abuse and diversion (eg, injection drug users). Patients who fail buprenorphine treatment should be referred for methadone- or abstinence-based treatment. CONCLUSION: Buprenorphine is an effective treatment of opioid addiction and can be safely prescribed by primary care physicians.
Topic(s):
General Literature
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Reference Links: View the PubMed citation for Buprenorphine: new treatment of opioid addiction in primary care