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首页> 外文期刊>The British journal of psychiatry : >Adjustment disorders in primary care: Prevalence, recognition and use of services
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Adjustment disorders in primary care: Prevalence, recognition and use of services

机译：初级保健中的适应障碍：服务的普及，认可和使用

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Background: Within the ICD and DSM review processes there is growing debate on the future classification and status of adjustment disorders, even though evidence on this clinical entity is scant, particularly outside specialised care. Aims: To estimate the prevalence of adjustment disorders in primary care; to explore whether there are differences between primary care patients with adjustment disorders and those with other mental disorders; and to describe the recognition and treatment of adjustment disorders by general practitioners (GPs). Method: Participants were drawn from a cross-sectional survey of a representative sample of 3815 patients from 77 primary healthcare centres in Catalonia. The prevalence of current adjustment disorders and subtypes were assessed face to face using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Multilevel logistic regressions were conducted to assess differences between adjustment disorders and other mental disorders. Recognition and treatment of adjustment disorders by GPs were assessed through a review of patients' computerised clinical histories. Results: The prevalence of adjustment disorders was 2.94%. Patients with adjustment disorders had higher mental quality-of-life scores than patients with major depressive disorder but lower than patients without mental disorder. Self-perceived stress was also higher in adjustment disorders compared with those with anxiety disorders and those without mental disorder. Recognition of adjustment disorders by GPs was low: only 2 of the 110 cases identified using the SCID-I were detected by the GP. Among those with adjustment disorders, 37% had at least one psychotropic prescription. Conclusions: Adjustment disorder shows a distinct profile as an intermediate category between no mental disorder and affective disorders (depression and anxiety disorders).
机译：背景：在ICD和DSM审查过程中，关于适应症的未来分类和状态的辩论日益增多，尽管该临床实体的证据很少，尤其是在专科护理之外。目的：评估初级保健中适应障碍的患病率;探讨患有适应障碍的初级保健患者与其他精神障碍患者之间是否存在差异;并描述全科医生（GP）对调节障碍的认识和治疗。方法：参与者来自加泰罗尼亚77个主要医疗中心的3815名患者的代表性样本的横断面调查。使用针对DSM-IV轴I障碍的结构性临床访谈（SCID-I）面对面评估当前适应障碍和亚型的患病率。进行多级逻辑回归分析以评估适应障碍和其他精神障碍之间的差异。通过回顾患者的计算机临床病史来评估全科医生对调节障碍的识别和治疗。结果：调整障碍的患病率为2.94％。适应障碍患者的心理生活质量得分高于重度抑郁症患者，但低于无精神障碍患者。与患有焦虑症和没有精神障碍的人相比，适应障碍中的自我感知压力也更高。 GP对调节障碍的认识很低：在使用SCID-I鉴定的110例病例中，只有2例被GP发现。在适应障碍患者中，有37％的患者至少有一种精神处方。结论：适应障碍表现出明显的特征，是介于无精神障碍和情感障碍（抑郁和焦虑症）之间的中间类别。

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