David Goldberg

David Goldberg
King's College London | KCL · Institute of Psychiatry

About

301
Publications
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42,877
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Publications

Publications (301)
Article
Full-text available
Objective: Disorders characterized by "distressing unexplained somatic symptoms" are challenging. In the ICD-11 Primary Health Care (PHC) Guidelines for Diagnosis and Management of Mental Disorders (ICD-11 PHC), a new category, bodily stress syndrome (BSS), was included to diagnose patients presenting unexplained somatic symptoms. The present stud...
Article
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Background A study conducted as part of the development of the Eleventh International Classification of Mental Disorders for Primary Health Care (ICD-11 PHC) provided an opportunity to test the relationships among depressive, anxious and somatic symptoms in PHC. Method Primary care physicians participating in the ICD-11 PHC field studies in five c...
Article
Background: Patients with treatment-resistant depression (TRD) suffer very significant morbidity and are at a disadvantage concerning optimal clinical management. There are high associated societal costs. Aims: A detailed analysis of health economic costs in the United Kingdom in a group manifesting a severe form of TRD in the 12 months before thei...
Chapter
The term “depression” is an umbrella that covers a large number of heterogeneous depressive disorders, with symptoms overlapping with other common mental disorders on the one hand, and chronic systemic disease on the other. It covers both disorders that definitely benefit from recognition and treatment by the clinician, and those that can be though...
Article
This pragmatic randomized controlled trial tested the effectiveness of long-term psychoanalytic psychotherapy (LTPP) as an adjunct to treatment-as-usual according to UK national guidelines (TAU), compared to TAU alone, in patients with long-standing major depression who had failed at least two different treatments and were considered to have treatm...
Article
This study aimed at obtaining views of Austrian general practitioners (GPs) regarding the appropriateness of the proposed new ICD11-PHC classifications 'anxious depression', 'bodily stress syndrome' and 'health anxiety'and on the usefulness of their diagnostic criteria in the general medical setting. This qualitative study used a focus group method...
Article
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For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the prim...
Article
The National Institute of Health and Care Excellence (NICE) in England and Wales recommends the combination of pharmacotherapy and psychotherapy for the treatment of moderate to severe depression. However, the cost-effectiveness analysis on which these recommendations are based has not included psychotherapy as monotherapy as a potential option. Fo...
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Article
Introduction The strengths and weaknesses of the 5th edition of the Diagnostic and Statistical Manual of the American Psychiatric Association are considered, and the likely form of the revised version of the International Classification of Disease, due to be released in the future is briefly considered. Commentary It is argued that there are a n...
Article
Previous research has described distinctive features for anxious and nonanxious forms of major depression. The concept of "mixed anxiety depression disorder" (MADD) refers to a milder degree of the anxious form of depression, since the depressive symptoms fall short of the number required for a diagnosis of major depression. It is argued that this...
Article
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Thombs and colleagues have shown that screening consecutive attendees in primary care settings in high income countries for depression is not worthwhile. However, it is dangerous to generalize from high income countries such as the USA to the rest of the world. The positive predictive value of any screening test for depression is affected by the pr...
Article
Earlier clinical studies have suggested consistent differences between anxious and non-anxious depression. The aim of this study was to compare parental pathology, personality and symptom characteristics in three groups of probands from the general population: depression with and without generalized anxiety disorder (GAD) and with other anxiety dis...
Chapter
This chapter describes the challenges involved in delivering mental illness services to the entire populations of low- and middle-income countries (LAMICs) in terms of poor resources, an inadequate supply of mental health staff and insufficient training of primary care doctors. The progress that has been made in providing mental health training to...
Article
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In my first months as a trainee at the Maudsley we met weekly with a genial tutor who took us through the whole of General Psychopathology , 50 to 100 pages at a time. Although this seemed an unimaginative way of organising what were optimistically called ‘tutorials’, the experience has stood me
Article
Abstract It is argued that there are problems with psychiatric classifications with major mental disorders since there are no clear dividing lines between the psychoses, and these problems are compounded with common mental disorders. There are three possible solutions: hierarchical systems, postulating frequent 'co-morbidity' between many different...
Article
Background The Arkhangelsk Oblast is an area the size of France with a sparsely distributed population. The existing primary care staff have had very little training in the management of mental health disorders, despite the frequency of these disorders in the population. They requested special teaching on depression, suicide, somatisation and alcoh...
Conference Paper
This presentation will describe issues currently facing the public hospital system for metropolitan Chicago. These include health disparities, growing rates of uninsured persons, budget reductions of the state Medicaid program, the trajectory of constraints on the county tax base limiting local subsidies to the hospital, and the recent record of ad...
Article
Full-text available
Background: The World Health Organization is revising the primary care classification of mental and behavioural disorders for the International Classification of Diseases (ICD-11-Primary Health Care (PHC)) aiming to reduce the disease burden associated with mental disorders among member countries. Objective: To explore the opinions of primary ca...
Article
Generalized anxiety disorder (GAD) is frequently co-morbid with major depression (MDD), and this becomes more so when the duration requirement is relaxed. Both anxiety diagnoses and anxious symptoms are more common in both unipolar and bipolar depression. This paper explores the relationship between anxious symptoms and GAD with both unipolar and b...
Article
Lam TP, Mak KY, Goldberg D, Lam KF, Sun KS. Western mental health training for Traditional Chinese Medicine practitioners. Objective: To investigate the impact of a Western mental health training course for Traditional Chinese Medicine (TCM) practitioners. Method: A combined qualitative and quantitative approach was applied to examine the changes i...
Chapter
At one time, it was asserted that the ‘worried well’ were treated in primary care, while true mental illnesses were seen by the mental illness services. This was not true when it was asserted, and is even less true now. The great majority of patients with common mental disorders are cared for within primary care, and many of those with severe menta...
Article
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Depression is more likely in patients with chronic physical illness, and is associated with increased rates of disability and mortality. Effective treatment of depression may reduce morbidity and mortality. The use of two stem questions for case finding in diabetes and coronary heart disease is advocated in the Quality and Outcomes Framework, and h...
Article
The concept of major depression, in both the ICD and the DSM, has been a flagship for mental health in general medical settings. It is the principal mental disorder emphasized to general practitioners and hospital doctors, and it has been used by governments to raise awareness of mental health issues in the population at large and in the medical co...
Article
There are increasing expectations on primary care doctors to care for patients with common mental health problems. This study examines the outcomes of a postgraduate training course in psychological medicine for primary care doctors. A questionnaire developed by the research team was sent to the Course graduates (year 2003-2007). A retrospective de...
Article
To review the efficacy of non-pharmacological treatment for depression in people with depression and chronic physical health problems. Five electronic databases were searched including EMBASE, Medline and PsycINFO for randomized controlled trials (RCTs). Each paper was assessed for quality, data extracted and, where possible, the data meta-analyzed...
Article
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Observed co-morbidity among the mood and anxiety disorders has led to the development of increasingly sophisticated dimensional models to represent the common and unique features of these disorders. Patients often present to primary care settings with a complex mixture of anxiety, depression and somatic symptoms. However, relatively little is known...
Article
The World Health Organization (WHO) is revising the ICD-10 classification of mental and behavioural disorders, under the leadership of the Department of Mental Health and Substance Abuse and within the framework of the overall revision framework as directed by the World Health Assembly. This article describes WHO's perspective and priorities for me...
Article
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Most studies showed that patients would first go to their primary care physicians (PCPs) when depressed. This choice is probably due to PCP being the entry point into the health care system. We studied the general population's initial choice of mental care in Hong Kong, where patients were unclear about family medicine and free to choose doctors of...
Article
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Antidepressant drugs are widely used in the treatment of depression in people with chronic physical health problems. To examine evidence related to efficacy, tolerability and safety of antidepressants for people with depression and with chronic physical health problems. Meta-analyses of randomised controlled efficacy trials of antidepressants in de...
Article
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The health care systems in many countries are focused on specialist care. In those countries that have recently changed to a primary care-based system, some doctors and patients were dissatisfied with the change. To explore the opinions of the general public and the doctors on the change to a family medicine (FM)-based health care system. Qualitati...
Article
A recent trend in health care system is to provide more choices to the patients. This study surveyed the general public's choices for primary care in Hong Kong which has the setting of free choices for private or public service and also direct access to specialists. We used a combined qualitative and quantitative approach. We held five focus group...
Article
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This paper 1 is an interesting and unusual data set that raises a number of questions, only some of which are answerable. Life expectancy has steadily increased from 1900 to 2000, while infant mortality has also steadily improved. Suicide rates have not kept pace with this general improvement in health by showing similar linear decreases. If we dis...
Article
This paper describes the process of preparing a Clinical Guideline for “NICE”, the National Institute for Health and Clinical Excellence in the United Kingdom. The procedure involves the group appointed to prepare the guideline relating to the various “stakeholders” who have an interest on the one hand, and satisfying the fairly demanding standards...
Article
This paper describes the process of preparing a Clinical Guideline for "NICE", the National Institute for Health and Clinical Excellence in the United Kingdom. The procedure involves the group appointed to prepare the guideline relating to the various "stakeholders" who have an interest on the one hand, and satisfying the fairly demanding standards...
Article
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Our major classification systems (DSM and ICD) face three main problems: the high rates of 'comorbidity' that are produced by our present diagnostic rules, the increasing use of 'not elsewhere classified' (NEC) by practising clinicians, and the fact that each new edition is longer and more complex than the one preceding it. A major simplification o...
Article
DEPRESSION AND CHRONIC PHYSICAL ILLNESS ARE IN RECIPROCAL RELATIONSHIP WITH ONE ANOTHER: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses. Depression associated with physical illness is less well detected than depression occurring on its own, and various w...
Article
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This article proposes a simplification to the chapter structure of current classifications of mental disorder, which cause unnecessary estimates of 'comorbidity' and pay major attention to symptom similarity as a criterion for deciding on groupings. A simpler system, taking account of recent developments in aetiology, is proposed. There is at prese...
Chapter
Prelingual deafness has a prevalence rate of 1 per 1,000 in the adult population. It entails far reaching communicative problems with profound consequences in cognitive, social and emotional development. In that context the term “deaf” is seen from a cultural perspective. The use of sign language is the most important factor in establishing a deaf...
Article
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This is one of a series of BMJ summaries of new guidelines, which are based on the best available evidence; they highlight important recommendations for clinical practice, especially where uncertainty or controversy exists. Why read this summary? Each year 6% of adults will experience an episode of depression, and over the course of a person's life...
Article
The organization of mental disorders into 16 DSM-IV and 10 ICD-10 chapters is complex and based on clinical presentation. We explored the feasibility of a more parsimonious meta-structure based on both risk factors and clinical factors. Most DSM-IV disorders were allocated to one of five clusters as a starting premise. Teams of experts then reviewe...
Article
The extant major psychiatric classifications DSM-IV, and ICD-10, are atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis would be greatly enhanced by an understanding of risk factors and clinical manifestations. In an effort to group mental disorders on the basis of aetiology, five clus...
Article
The extant major psychiatric classifications, DSM-IV and ICD-10, are purportedly atheoretical and largely descriptive. Although this achieves good reliability, the validity of a medical diagnosis is greatly enhanced by an understanding of both risk factors and clinical history. In an effort to group mental disorders on the basis of risk factors and...
Article
This paper reviews recent research with animals which has cast new light on the mechanism and consequences of maternal attachment, and goes on to describe research in humans which has investigated the extent to which the same mechanisms may apply to us. It is clear that while some features of the adult are mediated by genes, environmental factors –...
Article
The aim of this study was to elucidate factors related to the high rate of mental health disorders seen in those with impaired hearing, including social factors and audiological measures. A representative sample of 95 pupils (47 females, 48 males; mean age 11y 1mo, range 6y 5mo to 16y, SD 2y 7mo) with hearing impairments of at least 40dB and normal...
Article
Early identification of deaf-blindness is essential to ensure appropriate management. Previous studies indicate that deaf-blindness is often missed. We aim to discover the extent to which deaf-blindness in people with intellectual disability (ID) is undiagnosed. A survey was made of the 253 residents of an institute offering residential and occupat...
Article
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Mental disorders occur as frequently in Russia as elsewhere, but the common mental disorders, especially depression, have gone largely unrecognised and undiagnosed by policlinic staff and area doctors. Methods: This paper describes the impact and sustainability of a multi-component programme to facilitate the integration of mental health into prim...
Article
The aim of this study was to examine the relationship of language competence level and mental distress in teenagers with hearing impairments. 43 pupils were given a battery of linguistic tests and the Strengths and Difficulties Questionnaire (SDQ), which was also completed by 40 parents. Comparisons were made between the group of 33 children in mai...
Chapter
Primary care occupies a position of utmost importance in the management of mental health problems. A significant proportion of patients with mental health problems in primary care have a poor prognosis. Somatisation has been described as the expression of psychological distress through physical symptoms, and it appears to be a universal phenomenon...
Article
Full-text available
The public health significance of mixed anxiety-depressive disorder (MADD) and the distinctiveness of its phenomenology have yet to be established. To determine the public health significance of MADD, and to compare its phenomenology with ICD-10 anxiety, depressive, and comorbid anxiety and depressive disorders. Weighted analysis of data from the G...
Article
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This paper examines what has been achieved in the specialist mental health services by the vastly increased health expenditures that the National Health Service (NHS) has enjoyed in the past 5 years. To describe the way money has been spent in specialist mental health services and examine why problems remain after such admirable changes to already...
Article
This paper describes the setting up of training for family physicians in mental health skills, with the results obtained for the first 75 doctors who attended the course, in the city of Ekaterinburg, Russian Federation. Instruction was by lectures, discussion groups, and role-plays, initially using the World Psychiatric Association's (WPA) training...
Article
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To facilitate mental health reform in one Russian oblast (region) using systematic approaches to policy design and implementation. The authors undertook a three-year action-research programme across three pilot sites, comprising a multifaceted set of interventions combining situation appraisal to inform planning, sustained policy dialogue at federa...
Article
Many patients in primary care somatise psychological distress. Training general practitioners (GPs) to manage somatisation has been shown to lead to improvements in their management of these patients. However, the training has been intensive and conducted by psychiatrists, making it impractical for widespread use. The aim of this research was to de...
Article
Life events (LEs) are recognised to be important risk factors for common mental disorders (CMD). Their prominence may vary across age groups but this issue has received little systematic investigation. Data were analysed from the 2000 UK National Survey of Psychiatric Morbidity comprising 8,580 participants aged 16-74 years. A history of recent lif...
Article
Recent studies indicate that family doctors fail to detect a substantial proportion of minor psychiatric disorders, and there is considerable variation between doctors in their ability to make accurate assessments. Previous research had indicated that such ability was correlated with certain interviewing techniques and variables relating to the doc...
Article
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The close association between generalized anxiety disorder (GAD) and major depressive disorder (MDD) prompts questions about how to characterize this association in future diagnostic systems. Most information about GAD-MDD comorbidity comes from patient samples and retrospective surveys. To revisit the sequential and cumulative comorbidity between...
Article
This study aims to compare levels of psychological distress and the quality of life in the hard of hearing with levels reported by the signing deaf, and the hearing population. A total of 373 members of the Hard of Hearing Association completed the brief WHO's Quality of Life, 12-item General Health Questionnaire and Brief Symptom Inventory, and pr...
Article
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The close association between generalized anxiety disorder (GAD) and major depressive disorder (MDD) prompts questions about how to characterize them in future diagnostic systems. We tested whether risk factors for MDD and GAD are similar or different. The representative 1972-73 Dunedin birth cohort of 1037 males and females was followed to age 32...
Article
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Treatment options for depression include antidepressants, psychological therapy and a combination of the two. To develop cost-effective clinical guidelines. Systematic literature reviews were used to identify clinical, utility and cost data. A decision analysis was then conducted to compare the benefits and costs of antidepressants with combination...
Article
This review will start by considering studies of the genetic contribution to the liability to depression, and go on to consider some of the ways in which environmental factors can modify gene expression. This will lead on to the pathways by which the genetic factors also appear to control stressful life events in adolescence and adult life, and the...
Article
The A.U.T.P. Working Party on the Applied Uses of Television was set up after the A UTP/ASME Conference on Undergraduate Education in Psychiatry and Behavioural Science held in Manchester in 1971. A group of Position Papers on the Uses of Television in Teaching Psychiatry has been published by the Working Party (AUTP, 1977), under the chairmanship...
Article
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In the United Kingdom, the "Research Assessment Exercise" is used by central government as a way of distributing infra-structure funds to University departments to support research. Departments with the highest ratings get extra support, while departments with low ratings may have their existing support withdrawn. The paper describes an exercise ai...
Article
The National Institute of Clinical Excellence (NICE) in the UK is responsible for producing evidence based guidelines for the treatment of most common illnesses, both physical and psychological. NICE uses a hierarchy of evidence, ranging from data from meta-analyses of randomised controlled trials (RCT's) at the apex, to the opinions of acknowledge...
Article
Full-text available
The National Institute of Clinical Excellence (NICE) in the UK is responsible for producing evidence based guidelines for the treatment of most common illnesses, both physical and psychological. NICE uses a hierarchy of evidence, ranging from data from meta-analyses of randomised controlled trials (RCT's) at the apex, to the opinions of acknowledge...
Article
High risks of mental illness within the deaf community are reported. The assessment of the level of mental distress and quality of life in the deaf community is difficult due to communication problems in spoken and written language. The deaf community is characterized by the use of sign language. A new measure of acceptable reliability using sign l...
Article
Structured assessment of quality of life and mental distress in deaf people is difficult for various reasons. This paper describes the development and reliability of an interactive computer-based assessment package for measuring quality of life and psychological distress in the deaf population. The Brief version of the WHO Quality of Life (WHOQOL)...
Article
Full-text available
There is considerable evidence to suggest that the genetic vulnerabilities to depression and anxiety substantially overlap and quantitatively act to alter risk to both disorders. Continuous scales can be used to index this shared liability and are a complementary approach to the use of clinical phenotypes in the genetic analysis of depression and a...