Evaluación e intervención de los problemas de Ansiedad y Depresión en Atención Primaria: Un problema sin resolver.

Revista Clínica de Medicina de Familia 01/2012; 5(1):37-45. DOI: 10.4321/S1699-695X2012000100007

ABSTRACT RESUMEN Los problemas de salud mental, especialmente los de ansiedad y depresión, suponen aproximadamente una de cada cuatro consultas que reciben los médicos de atención primaria. En este trabajo se presenta una revisión que pretende responder a dos preguntas interrelacionadas. En primer lugar, ¿cómo abordan los médicos de atención primaria el diagnóstico y el tratamiento de la ansiedad y depresión? Y en segundo lugar, ¿cómo se puede solucionar el problema? Para responder a la segunda pregunta vamos a tratar los siguientes aspectos: las necesidades de formación de los médicos de atención primaria, el desarrollo de instrumentos de evaluación a las características de la atención primaria, así como el incremento del número de profesionales sanitarios dedicados a la salud mental. ABSTRACT unsolved problem The mental health problems, especially anxiety and depression, represent approximately one in every four visits received by primary care physicians. In this paper we present a review that aims to answer two interrelated questions. First, how primary care physicians diagnose and treat anxiety and depression? And secondly, how can we solve the problem? To answer the second question we will discuss the following aspects: the training needs of primary care physicians, psychotherapeutic techniques adapted to the characteristics of the primary care setting as well as the increasing number of health professionals dedicated to mental health.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Studies indicate that persons with anxiety disorders seek treatment from general medical facilities as often as they do from mental health care settings. Yet primary care providers often do not recognize and treat these individuals effectively, perhaps because anxiety disorders present differently in the general health setting. In light of this situation, the authors note the need to disseminate efficacious treatment approaches to primary care settings. With this goal in mind, they review the prevalence of anxiety in the community and in primary care patients, the presentation of anxiety disorders in primary care, how to improve recognition of anxiety and depression in primary care, and treatment strategies for primary care providers.
    Bulletin of the Menninger Clinic 02/1995; 59(2 Suppl A):A73-85. · 0.72 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mental disorders tend to be seen first in primary care settings around the world. To be helpful, classifications of mental disorders for primary care need to be simple. In response to these basic observations and requirements, a primary care version of the mental disorder section of ICD-10 has been developed by the WHO (ICD-10-PHC). This classification version has been used quite extensively internationally. The results of field trials with ICD-10-PHC are summarised here along with recommendations to make classifications and information systems more helpful to upgrade primary care of mental disorders around the world.
    Psychopathology 01/2002; 35(2-3):127-31. · 1.62 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: It is argued that a general practitioner's ability to make accurate ratings of psychological distress is partly determined by the rate at which patients emit cues that are indicative of such distress. This study addresses the behaviours of doctors which influence the rates at which patients emit such cues. Consultations were videotaped involving six General Practice Vocational Trainees, three of them poor, and three of them able identifiers of emotional illness. Consultations were selected so that each trainee was rated interviewing 4 patients with low GHQ scores, and 4 patients with high scores. Behaviours are described which lead to increased cue emission and which are also practised more frequently by able identifiers, while other behaviours reduce cue emission and are practised less frequently by them. Another set of behaviours is no more frequent among the able identifiers, but when practised by able identifiers is associated with increased cue emission by the patients, and when practised by poor identifiers with unaltered or decreased cue emission. Interviews that are 'patient-led' are associated with increased rates of cue emission, while those that are 'doctor-led' are associated with lower rates. The implications of these findings for training doctors working in general medical settings are discussed.
    Psychological Medicine 03/1993; 23(1):185-93. · 5.59 Impact Factor


Available from
Jun 1, 2014