This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Related articles in BJP
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by CROUDACE, T.
Right arrow Articles by BRINDLE, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by CROUDACE, T.
Right arrow Articles by BRINDLE, L.
The British Journal of Psychiatry (2003) 182: 20-30
© 2003 The Royal College of Psychiatrists

Impact of the ICD-10 Primary Health Care (PHC) diagnostic and management guidelines for mental disorders on detection and outcome in primary care

Cluster randomised controlled trial{dagger}

TIM CROUDACE, PhD

Department of Psychiatry University of Cambridge, UK

JONATHAN EVANS, MRCPsych and GLYNN HARRISON, FRCPsych

Division of Psychiatry, University of Bristol, UK

DEBORAH J. SHARP, FRCGP

Division of Primary Health Care, University of Bristol, UK

ELLEN WILKINSON, MRCPsych, GEMMA McCANN, BA, MATHEW SPENCE, BSc, CATHERINE CRILLY, MRCGP and LUCY BRINDLE, BSc

Division of Psychiatry, University of Bristol, UK

Correspondence: Tim Croudace, Department of Psychiatry, University of Cambridge, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK

Declaration of interest D.J.S. was involved in the development of the WHO guidelines.

{dagger} See editorial, pp. 1–2, this issue.

Background The World Health Organization (WHO) ICD-10 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (1996) have not been evaluated in a pragmatic randomised controlled trial (RCT).

Aims To evaluate the effect of local adaptation and dissemination of the guidelines.

Method Pragmatic, pair-matched, cluster RCT involving 30 practices.

Results Guideline practices were less sensitive but more specific in identifying morbidity, but these differences were not significant. Guideline patients did not differ from usual-care patients on 12-item General Health Questionnaire scores at 3-month follow-up or in the proportion who were still cases. There were no significant differences in secondary outcomes.

Conclusions Attempts to influence clinician behaviour through a process of adaptation and extension of guidelines are unlikely to change detection rates or outcomes.


Related articles in BJP:

Detection and management of psychiatric disorders in primary care
JOHN E. COOPER
BJP 2003 182: 1-2. [Full Text]  

Highlights of this issue
ELIZABETH WALSH
BJP 2003 182: 1-a2. [Full Text]  

Psychiatry in pictures
ROBERT HOWARD
BJP 2003 182: 1-a3. [Full Text]  



This article has been cited by other articles:


Home page
 Transcultural PsychiatryHome page
D. Healy
Trussed in Evidence? Ambiguities at the Interface between Clinical Evidence and Clinical Practice
Transcultural Psychiatry, March 1, 2009; 46(1): 16 - 37.
[Abstract] [PDF]

Home page
 Br. J. PsychiatryHome page
D. L. FONE, F. DUNSTAN, A. JOHN, and K. LLOYD
Associations between common mental disorders and the Mental Illness Needs Index in community settings: Multilevel analysis
The British Journal of Psychiatry, August 1, 2007; 191(2): 158 - 163.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
K S Jacob
The diagnosis and management of depression and anxiety in primary care: the need for a different framework
Postgrad. Med. J., December 1, 2006; 82(974): 836 - 839.
[Full Text] [PDF]

Home page
 Int J Qual Health CareHome page
B. Fervers, J. S. Burgers, M. C. Haugh, J. Latreille, N. Mlika-Cabanne, L. Paquet, M. Coulombe, M. Poirier, and B. Burnand
Adaptation of clinical guidelines: literature review and proposition for a framework and procedure.
Int. J. Qual. Health Care, June 1, 2006; 18(3): 167 - 176.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
E. England
Improving the management of dementia.
BMJ, March 25, 2006; 332(7543): 681 - 682.
[Full Text] [PDF]

Home page
 Qual Saf Health CareHome page
S M Campbell, J Robison, A Steiner, D Webb, and M O Roland
Improving the quality of mental health services in Personal Medical Services pilots: a longitudinal qualitative study
Qual. Saf. Health Care, April 1, 2004; 13(2): 115 - 120.
[Abstract] [Full Text] [PDF]

Home page
 Evid. Based Ment. HealthHome page
M. Linden
Local adaptation of guidelines for identifying mental disorders in primary care may not improve patient outcomes
Evid. Based Ment. Health, August 1, 2003; 6(3): 78 - 78.
[Full Text] [PDF]

Home page
 Br. J. PsychiatryHome page
B. COOPER
Evidence-based mental health policy: a critical appraisal
The British Journal of Psychiatry, August 1, 2003; 183(2): 105 - 113.
[Abstract] [Full Text] [PDF]

Home page
 Br. J. PsychiatryHome page
P. Tyrer, M. King, and J. Fluxman
Treatment of common mental disorders in general practice: are current guidelines useless?
The British Journal of Psychiatry, July 1, 2003; 183(1): 78 - 78.
[Full Text] [PDF]

Home page
 BMJHome page
Minerva
BMJ, January 25, 2003; 326(7382): 232 - 232.
[Full Text] [PDF]

Home page
 Br. J. PsychiatryHome page
J. E. COOPER
Detection and management of psychiatric disorders in primary care
The British Journal of Psychiatry, January 2, 2003; 182(1): 1 - 2.
[Full Text] [PDF]