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Evaluation of ICD-10 PHC mental health guidelines in detecting and managing depression within primary care

Published online by Cambridge University Press:  03 January 2018

Mark W. M. Upton ,
Maggie Evans ,
David P. Goldberg  and
Deborah J. Sharp
Mark W. M. Upton*
Affiliation:
Division of Psychiatry, University of Bristol
Maggie Evans
Affiliation:
Division of Primary Care, University of Bristol
David P. Goldberg
Affiliation:
Institute of Psychiatry, London
Deborah J. Sharp
Affiliation:
Division of Primary Care, University of Bristol
*
Dr Mark Upton, Burden Neurological Hospital, Stoke Lane, Stapleton, Bristol BS15 1QT
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Abstract

Background

The prevalence of mental disorders in the community is high, yet many remain unrecognised, misdiagnosed or poorly managed within primary care. Hence, guidelines for diagnosing and managing mental disorders in primary care, ICD–10 PHC, have been developed.

Aims

To introduce the guidelines into primary care and to assess whether they improve recognition, accuracy of diagnosis and treatment standards.

Method

GPs recorded information on all patients presenting with mental disorders before and after guidelines were introduced. A10% sample of patients underwent interviews to establish a formal diagnosis. Recognition of mental disorders was assessed by screening of patients attending their GP.

Results

The guidelines had no impact on the overall detection of mental disorders, the accuracy of diagnosis or the prescription of antidepressants. There was a significant increase in the number of patients diagnosed with depression or unexplained somatic symptoms. The GPs also made increased use of psychological interventions.

Conclusions

The success of the guidelines in bringing about change is by no means certain. Some areas appeared more susceptible to change than others.

Type
Papers
Information
The British Journal of Psychiatry , Volume 175 , Issue 5 , November 1999 , pp. 476 - 482
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

†

See invited commentaries, p. 483, this issue.

Declaration of interest

Funding was provided by the Department of Health.

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