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首页> 外文期刊>BMC Family Practice >Generalized anxiety disorder in primary care: mental health services use and treatment adequacy
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Generalized anxiety disorder in primary care: mental health services use and treatment adequacy

机译：初级保健中的广泛性焦虑症：精神卫生服务的使用和治疗的充分性

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Purpose Generalized Anxiety Disorder (GAD) is a common mental disorder in the primary care setting, marked by persistent anxiety and worries. The aims of this study were to: 1) examine mental health services utilisation in a large sample of primary care patients; 2) explore detection of GAD and minimal standards for pharmacological and psychological treatment adequacy based on recommendation from clinical practice guidelines; 3) examine correlates of treatment adequacy, i.e. predisposing, enabling and needs factors according to the Behavioural Model of Health Care Use. Methods A sample of 373 adults meeting DSM-IV criteria for Generalized Anxiety Disorder in the past 12?months took part in this study. Data were drawn from the “Dialogue” project, a large primary care study conducted in 67 primary care clinics in Quebec, Canada. Following a mental health screening in medical clinics (n?=?14833), patients at risk of anxiety or depression completed the Composite International Diagnostic Interview-Simplified (CIDIS). Multilevel logistic regression models were developed to examine correlates of treatment adequacy for pharmacological and psychological treatments. Results Results indicate that 52.5?% of participants were recognized as having GAD by a healthcare professional in the past 12?months, and 36.2?% of the sample received a pharmacological (24.4?%) and/or psychological treatment (19.2?%) meeting indicators based on clinical practice guidelines recommendations. The detection of GAD by a health professional and the presence of comorbid depression were associated with overall treatment adequacy. Conclusions This study suggests that further efforts towards GAD detection could lead to an increase in the delivery of evidence-based treatments. Key targets for improvement in treatment adequacy include regular follow up of patients with a GAD medication and access to psychotherapy from the primary care setting.
机译：目的广泛性焦虑症（GAD）是基层医疗机构中常见的精神障碍，其特征是持续存在焦虑和忧虑。这项研究的目的是：1）检查大量初级保健患者中心理健康服务的利用; 2）根据临床实践指南的建议，探索GAD的检测方法以及药理和心理治疗充分性的最低标准; 3）根据卫生保健使用行为模型，检查治疗充分性的相关性，即易感性，促成因素和需要因素。方法在过去的12个月中，对373名符合DSM-IV标准的成人焦虑症成年人进行了抽样研究。数据来自“对话”项目，该项目是在加拿大魁北克的67个初级保健诊所进行的大型初级保健研究。在医疗诊所进行精神健康筛查（n = 14833）之后，有焦虑或抑郁风险的患者完成了简化的综合国际诊断访谈（CIDIS）。建立了多级逻辑回归模型以检查药理和心理治疗的适当性之间的相关性。结果结果表明，在过去的12个月中，有52.5％的参与者被卫生保健专业人员识别为患有GAD，并且36.2％的样本接受了药理学（24.4％）和/或心理治疗（19.2 %%）。根据临床实践指南建议满足指标。卫生专业人员对GAD的检测以及共存性抑郁症的存在与总体治疗的充分性有关。结论本研究表明，进一步检测GAD可能会导致循证治疗的增加。改善治疗充分性的关键目标包括对接受GAD药物治疗的患者进行定期随访，以及从初级保健机构接受心理治疗。

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