Frank mental disorders, such as depression and panic disorder, are prevalent in primary care; they cause people substantial suffering and interfere with daily functioning. Even subthreshold or "subsyndromal" conditions, with fewer symptoms than necessary for making a diagnosis, cause substantial morbidity. Recent literature on mental disorders in primary care, where many, if not most, people with mental health problems are seen, is reviewed with focus on recognition and diagnosis issues, management of these problems in primary care, obstacles to accurate diagnosis and appropriate treatment, and prevention issues. In addition to a review of recent research, there is an effort to place these topics in the context of various directives, including research and Federal documents, that have direct implications for better treatment in primary care of people with mental disorders (for example, practice guidelines). Mental health problems and disorders seen in primary care are a public health problem meriting immediate attention and substantial work at many levels--clinical, educational, organizational, and budgetary.
Bostelman, S; Callan, M; Rolincik, L C; Gantt, M; Herink, M; King, J; Massey, M K; Morehouse, D; Sopata, T; Turner, J;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):153-157
Description:
Rehospitalization of mentally ill persons has been associated mainly with two major factors, noncompliance with the prescribed course of medication and noncompliance with planned aftercare. The authors developed and pilot tested a community health pr...
McCusker, J; Willis, G; McDonald, M; Lewis, B F; Sereti, S M; Feldman, Z T;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):212-218
Description:
The outcomes of counseling and testing programs related to human immunodeficiency virus (HIV) infection and risk of infection among injection drug users (IDUs) are not well known or understood. A counseling and testing outcome of potential public hea...
Palfrey, J S; Haynie, M; Porter, S; Fenton, T; Cooperman-Vincent, P; Shaw, D; Johnson, B; Bierle, T; Walker, D K;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):226-233
Description:
In 1987 and 1990 in Massachusetts, surveys were conducted to determine the size, pattern of distribution, and trends in the population of children assisted by medical technology. The authors obtained an unduplicated count of all Massachusetts childre...
Graduates of MEDEX Northwest, the physician assistant training program at the University of Washington, were surveyed to describe differences between physician assistants practicing in rural settings and those practicing in urban settings. Difference...
The question of identifying and treating childhood illness confronts all new parents. Misconceptions often lead parents to manage illnesses in their young children inappropriately through overly aggressive treatment or insufficient attention. This re...
Teenagers are a crucial target group for interventions concerning acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV). Experimenting with their burgeoning sexuality and increased ability to obtain drugs, they are prime ca...
Increasingly, public health interventions are dependent on effective health communications. There are, however, few data examining the relationship and interactions between local public health officers and representatives of the media in the literatu...
Bicycle helmet use in the United States has remained low despite clear demonstration of its beneficial effect on reducing the incidence of serious head injury. Several interventions have been reported, with variable results and costs. Much of the rec...
The American public saved more than $39 billion (1990 dollars) in dental expenditures from 1979 through 1989 in contrast to the substantial increases in expenditures in other sectors of the U.S. health care system that have pushed the system to the b...
Violence is devastating the lives of children in America's major cities. The problem of violence is particularly acute among disadvantaged young urban males. This program focuses on violence prevention in school-age boys using creative educational te...
The purpose of the study is to determine the educational needs of public health officials concerning their knowledge, attitude, beliefs, and practices with specific reference to ionizing radiation. The public health directors or designates, working i...
Onorato, Ida M.; Gwinn, Marta; Dondero, Timothy J.;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):204-211
Description:
The CDC Family of Surveys is a national serologic surveillance system set up to characterize the extent of human immunodeficiency virus (HIV) infection in the United States. The now Centers for Disease Control and Prevention (CDC) and participating S...
Sugarman, Jonathan R.; Brenneman, George; LaRoque, William; Warren, Charles W.; Goldberg, Howard I.;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):243-250
Description:
Although more than two-thirds of American Indians and Alaska Natives (AI) live outside reservations and Tribal lands, few data sets describe social and maternal-child health risk factors among urban AI. The Indian Health Service sponsored a special e...
Thacker, Stephen B.; Koplan, Jeffrey P.; Taylor, William R.; Hinman, Alan R.; Katz, Martha F.; Roper, William L.;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):187-194
Description:
The measure of the effectiveness of health promotion and disease prevention activities is the impact of prevention policies, programs, and practices on public health and clinical medicine. Assessing prevention effectiveness involves continuing quanti...
AgĂłcs, Mary M.; Trent, Roger B.; Russell, Deborah M.;
Published Date:
1994 Mar-Apr
Source:
Public Health Rep. 109(2):290-295
Description:
Statewide surveillance in California determined that the highest drowning rate from 1980 through 1989 was for the rural, desert county of Imperial (21.9 drownings per 100,000 population). To identify activities associated with drowning in this county...
Knowing the reasons some physicians do not adhere to the disease prevention and treatment recommendations of expert committees can assist in the development of future recommendations more likely to be adopted by physicians. The authors describe the a...
This study investigated the self-reported awareness of the presence of product warning messages and signs among random samples of Hispanics in San Francisco surveyed in 1990 and in 1991. The messages that were tested related to cigarettes, alcoholic ...
This paper reviews restraints on the provision of mental health services in primary health care under the broad categories of physician profile, patient behavior, the nature of psychiatric illness as presented in primary care, and service system char...
Hogan, Michael F.; Sederer, Lloyd I.; Smith, Thomas E.; Nossel, Ilana R.;
Published Date:
Oct 15 2010
Source:
Prev Chronic Dis. 7(6).
Description:
Discussions of health care reform emphasize the need for coordinated care, and evidence supports the effectiveness of medical home and integrated delivery system models. However, mental health often is left out of the discussion. Early intervention a...
National Center for Health Statistics (U.S.). Division of Health Utilization Statistics.
Published Date:
July 23, 1979
Series:
Advance data from vital and health statistics of the National Center for Health Statistics ; no. 50
DHEW publication ; no. (PHS) 79-1250
Description:
Presented in this report are data about the estimated 90.5 million office visits made by black ambulatory patients over the 2-year span from January 1975 through December 1976. The data, which are contrasted with corresponding data for the overall vi...
National Center for Health Statistics (U.S.). Division of Health Utilization Statistics.
Published Date:
April 13, 1979
Series:
Advance data from vital and health statistics of the National Center for Health Statistics ; no. 48
DHEW publication ; no. (PHS) 79-1250
Description:
During 1977 an estimated 570.0 million office visits—an average of 2.7 per person per year-were made to nonfederally employed, office-based physicians in the conterminous United States. These and other estimates presented in this report are based o...
File Type:
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