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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).
11231 Results
1601
Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: The negative consequences of untreated postpartum depression (PD) for both the woman and her infant are well established. The impact of maternal depression has led to recommendations on systematic perinatal depression screening. Unfortunately, large-scale initiatives on PD screening have found no benefit unless systems are in place to facilitate appropriate interventions for women who screen positive. Pediatric primary care has been a focus of efforts to support screening and management of PD because pediatric providers, unlike adult healthcare providers, have the most frequent contact with postpartum women through well-child visits. Well-child visits thus present an unparalleled opportunity to detect and intervene with PD. Literature reviews suggest that specific strategies are feasible within pediatric settings and could benefit both the woman and her child. In this article, we present a stepped care approach for screening and managing PD, integrating common elements found in existing pediatric-based models. A stepped care approach is ideal because PD is a heterogeneous condition, with a range of presentations and hence responsiveness to various interventions. This care pathway begins with systematic screening for depression symptoms, followed by a systematic risk assessment for women who screen positive and care management based on risk profiles and responsiveness. This approach allows pediatric providers to be optimally flexible and responsive in addressing the majority of women with PD within the context of the family-centered medical home to improve child well-being. Challenges to managing PD within pediatrics are discussed, including strategies for addressing them. Implications for research, policy, and practice are discussed.
Topic(s):
Education & Workforce
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Reference Links: 
View the DOI record for Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings
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View the PubMed citation for Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings1602
Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS)
Type: Journal Article
Year: 2003
Publication Place: England
Abstract: Patients commonly present in primary care with symptoms for which no physical pathology can be found. This study is a review of published research on medically unexplained symptoms (MUPS) in primary care. A literature review and qualitative comparison of information was carried out. Four questions were addressed: what is the prevalence of MUPS; to what extent do MUPS overlap with psychiatric disorder; which psychological processes are important in patients with MUPS; and what interventions are beneficial? Neither somatised mental distress nor somatisation disorders, based on symptom counts, adequately account for most patients seen with MUPS. There is substantial overlap between different symptoms and syndromes, suggesting they have much in common. Patients with MUPS may best be viewed as having complex adaptive systems in which cognitive and physiological processes interact with each other and with their environment. Cognitive behavioural therapy and antidepressant drugs are both effective treatments, but their effects may be greatest when the patient feels empowered by their doctor to tackle their problem.
Topic(s):
Medically Unexplained Symptoms
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Reference Links: View the PubMed citation for Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS)
1603
Beyond state scope of practice laws for advanced practitioners: Additional supervision requirements for buprenorphine prescribing
Type: Journal Article
Year: 2022
Publication Place: United States
Topic(s):
Education & Workforce
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, Healthcare Policy
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, Opioids & Substance Use
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1604
Beyond symptoms: defining primary care mental health clinical assessment priorities, content and process
Type: Journal Article
Year: 2012
Publication Place: England
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Beyond symptoms: defining primary care mental health clinical assessment priorities, content and process
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View the PubMed citation for Beyond symptoms: defining primary care mental health clinical assessment priorities, content and process1605
Beyond the limits of clinical governance? The case of mental health in English primary care
Type: Journal Article
Year: 2008
Publication Place: England
Abstract: BACKGROUND: Little research attention has been given to attempts to implement organisational initiatives to improve quality of care for mental health care, where there is a high level of indeterminacy and clinical judgements are often contestable. This paper explores recent efforts made at an organisational level in England to improve the quality of primary care for people with mental health problems through the new institutional processes of 'clinical governance'. METHODS: Framework analysis, based on the Normalisation Process Model (NPM), of attempts over a five year period to develop clinical governance for primary mental health services in Primary Care Trusts (PCTs). The data come from a longitudinal qualitative multiple case-study approach in a purposive sample of 12 PCTs, chosen to reflect a maximum variety of organisational contexts for mental health care provision. RESULTS: The constant change within the English NHS provided a difficult context in which to attempt to implement 'clinical governance' or, indeed, to reconstruct primary mental health care. In the absence of clear evidence or direct guidance about what 'primary mental health care' should be, and a lack of actors with the power or skills to set about realising it, the actors in 'clinical governance' had little shared knowledge or understanding of their role in improving the quality of mental health care. There was a lack of ownership of 'mental health' as an integral, normalised part of primary care. CONCLUSION: Despite some achievements in regard to monitoring and standardisation of prescribing practice, mental health care in primary care seems to have so far largely eluded the gaze of 'clinical governance'. Clinical governance in English primary mental health care has not yet become normalised. We make some policy recommendations which we consider would assist in the process normalisation and suggest other contexts to which our findings might apply.
Topic(s):
Education & Workforce
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Reference Links:
View the DOI record for Beyond the limits of clinical governance? The case of mental health in English primary care
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View the PubMed citation for Beyond the limits of clinical governance? The case of mental health in English primary care1606
Beyond the Treatment Box: Perspectives on the Federal Response to Opioid Use, Pregnancy, and Neonatal Abstinence Syndrome
Type: Journal Article
Year: 2017
Publication Place: United States
Abstract: : There has been much activity within Federal agencies in response to the opioid epidemic particularly in regards to pregnant women and their infants. Substance Abuse and Mental Health Services Administration's recently released document, Advancing the Care of Pregnant and Parenting Women With Opioid Use Disorder and Their Infants: A Foundation for Clinical Guidance, provides an important and timely guidance. Uptake of the guide should improve quality of care and hopefully help lessen the discrimination experienced by pregnant women with opioid use disorder. However, most pregnant women with addiction do not have access to treatment. This unmet need is large and vexing and only tangentially addressed in the Guide. Future Federal efforts should focus beyond the "treatment box."
Topic(s):
Healthcare Disparities
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, Opioids & Substance Use
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1613
Billing effectively with the new health and behavior current procedural terminology codes in primary care and specialty clinics
Type: Journal Article
Year: 2006
Publication Place: United States
Abstract: The health and behavior current procedural terminology (CPT) codes introduced in 2003 have gained nationwide acceptance through Medicare and limited acceptance through third party payers. The codes facilitate accurate description and quantification of behavioral medicine services within a primary care or specialty clinic setting. The author reviews their appropriate utilization to enhance reimbursement and facilitate development of self-sustaining behavioral medicine programs. Information is provided on increased use and reimbursement of codes within psychology. Future directions for continued advocacy, increased acceptance, training, and research are discussed.
Topic(s):
Financing & Sustainability
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, Healthcare Policy
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1616
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
1617
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 treatment1618
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
View DOI Record
View the PubMed citation for Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment1620
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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Reference Links:
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 patients