In the years prior to publication, primary health care had been gaining in significance as a setting both for research on mental illness in the general population and for the development of new preventive approaches in this field. The growing need for research had received impetus from the escalating costs of hospital-based health care, the re-structuring of health services in a number of countries, with an increased emphasis on community care and prevention, and the World Health Organization’s ‘Health for All’ campaign, in response to which a growing number of national planning documents had been published. These developments had already stimulated a new interest in the scope for epidemiological and evaluative investigations based on general medical practice.
This book, originally published in 1992, consists of selected contributions to the first international scientific meeting on this topic, held in Toronto in 1989. It is made up of five sections, dealing respectively with: the growth and development of a new research field; findings of psychiatric surveys in general practice in a number of different countries; specialist and generalist medical care for mental illness – issues of selection and referral; and specialist aspects of late-life mental disorders encountered in such research. The inclusion of reports from groups of workers in the USA, the UK, the Netherlands, Germany, Spain, Italy, Finland, Canada, Australia and other countries testifies to the rapid spread of interest in these questions.
With the exception of the first two chapters, which sketch the background of public-health and general-practice epidemiology, all the contributions are focused on general practice as a field laboratory for study of the occurrence, distribution, diagnostic composition and risk factors of psychiatric illness in unselected populations, and present data, largely unpublished, from the authors’ own projects. These findings confirm the importance of research in general practice as a major growing-point of social psychiatry and provide guidelines for further progress in the years ahead.
This book will still be an invaluable source of reference to all psychiatrists, psychologists, general practitioners and health care professionals concerned with mental disorders in the wider community.
Table of Contents
List of Figures and Tables. List of Contributors. Preface. Part 1: Psychiatric Epidemiology and General Practice: The Development of a Research Field 1. The Science of Epidemiology: Empirical Data Gathering, Public-Health Action, or Both? Leon Eisenberg 2. Psychiatric Illness, Epidemiology and the General Practitioner Brian Cooper 3. The ‘Research Magnificent’ Comes of Age Michael Shepherd 4. Primary Care and Psychiatric Epidemiology: The Psychiatrist’s Perspective David Goldberg and Linda Gask Part 2: Psychiatric Field Surveys in the Primary Health-Care Setting: An International Perspective 5. Psychiatric Morbidity in General Practice: A Community-Wide Perspective Alex Richman 6. Mental Health Care in Primary Health Care: A Case for Action Morton Kramer, Eleanor Simonsick, Bruno Lima and Itzhak Levav 7. Psychiatric Illness and Services in a UK Health Centre Brian Jarman 8. Psychosocial Complaints in General Practice: A National Survey in the Netherlands Peter F. M. Verhaak, Joke M. Bosman, Marleen Foets and Koos van der Velden 9. Psychiatric Morbidity and Physical Illness Among General Practice Patients in Cantabria, Spain J.L. Vázquez-Barquero 10. Mental Disorders in Primary Care in a Health District of Bahia, Brazil N.M. de Almeida-Filho, V.S. Santana, E.C. Moreira, M.G. Modesto and M.B. Oliveira 11. Use of Services by Homeless and Disaffiliated Individuals with Severe Mental Disorders: A Study in Melbourne Helen Herrman, Patrick McGorry, Pamela Bennett, Katrina Varnavides and Bruce Singh Part 3: Psychiatric and Medical Services: Issues of Patient Selection, Referral and Treatment 12. The Relationship of Usual Source of Health Care to the Prevalence of Psychiatric Disorder and the Utilization of Ambulatory Mental Health Services in the United States Martha L. Bruce, Gary L. Tischler and Philip J. Leaf 13. Care of Mental Health Problems in Finland: Selection Between Primary Medical and Psychiatric Specialist Services V. Lehtinen, M. Joukamaa, T. Jyrkinen, K. Lahtela, R. Raitasalo, J. Maatela and A. Aromaa 14. Psychiatric Morbidity in General Practice in Verona: The Importance of Parallel Studies at the Primary and Specialist Levels of Health Care M. Tansella, C. Bellantuono and P. Williams 15. Prescribing of Psychotropic Drugs by Primary-Care Physicians and Psychiatrists: A Study in Iceland Tómas Helgason Part 4: Late-Life Mental Disorders and Primary Health Care 16. Late-Life Mental Disorders and Primary Health Care: A Review of Research Brian Cooper 17. Prevalence and One-Year Course of Dementia in an English City: An Application of CAMDEX Daniel W. O’Connor and Penelope Pollitt 18. Cognitive Disorders and Dementia Among Elderly General-Practice Patients in a West German City Horst Bickel 19. Dementia: Case Ascertainment and Health Service Utilization in a US Rural Comminity Mary Ganguli, Lewis H. Kuller, Steven Belle, Graham Ratcliff, F. Jacob Huff and Katherine M. Detre Part 5: Problems of Method: Case-Finding, Classification and Taxonomy 20. Identification of Psychiatric Cases in Primary Health-Care Settings: The Utility of Two-Phase Screening Designs Patrick E. Shrout 21. The Latent Structure of Anxiety and Depression in Treated and Untreated Samples of Two US Populations William W. Eaton, and Howard D. Chilcoat 22. Psychiatric Syndromes Among Persons in Contact with General Medical and Psychiatric Services in Eastern Baltimore James C. Anthony, Alan J. Romanoski, Gerald Nestadt, Daniel E. Ford and Morton Kramer 23. Somatization in Primary Health Care: Prevalence and Determinants K.W. Bridges and D.P. Goldberg. Index
Brian Cooper, Robin Eastwood