RT Journal Article
SR Electronic
T1 Primary care patients with mental health problems: outcome of a randomised clinical trial
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 886
OP 891
VO 57
IS 544
A1 Bettine Schreuders
A1 Harm van Marwijk
A1 Jan Smit
A1 Frank Rijmen
A1 Wim Stalman
A1 Patricia van Oppen
YR 2007
UL http://bjgp.org/content/57/544/886.abstract
AB Background The prevalence of patients with mental health problems in general practice is high, and at least one-third of these problems last for 6 months or longer. Patients with these problems take up more time during a consultation and attend more frequently.Aim This study investigated the effectiveness of problem-solving treatment for primary care patients with mental health problems. The hypothesis was that patients receiving problem-solving treatment from a nurse would have fewer symptoms after 3 months, or a lower attendance rate, compared with patients receiving the usual care from the GP.Design of the study Randomised clinical trial.Setting Twelve general practices in Amsterdam and 12 nurses from a mental healthcare institution.Method A sample of patients aged ≥18 years were screened for mental health problems with the general health questionnaire (GHQ–12) in the waiting room of the general practices, and were randomised. Patients receiving the problem-solving treatment were required to complete four to six treatment sessions, while patients in the control group were treated as usual by the GP.Results No significant difference was found between the groups in terms of improved psychopathology or a decrease in attendance rate. Post-hoc analyses showed a sub-group of patients with more severe pathology who may benefit from problem-solving treatment.Conclusion The main results show that problem-solving treatment provided by a nurse adds little to the usual care from the GP for frequent attenders with mental health problems. Post-hoc analyses show that there may be a sub-group of more severely depressed patients who could benefit from problem-solving treatment.