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The chronically mentally ill in primary care.

D A Regier, J D Burke, R W Manderscheid

    Psychological Medicine
    |May 1, 1985
    PubMed
    Summary
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    Primary care physicians encounter many patients with chronic mental disorders, often undiagnosed. These conditions significantly impair daily functioning, highlighting the need for integrated mental health services in primary care settings.

    Area of Science:

    • Psychiatry
    • General Practice
    • Public Health

    Background:

    • Primary care physicians play a crucial role in managing patients with chronic mental illness.
    • Addressing mental health needs within primary care requires understanding prevalence and impact.
    • Integration of mental health services is vital for comprehensive patient care.

    Purpose of the Study:

    • To examine the role of primary care physicians in managing chronically mentally ill patients.
    • To assess the prevalence and impact of mental disorders in primary care settings.
    • To explore the treatment of chronic medical and mental health conditions within human service contexts.

    Main Methods:

    • Prevalence assessment of mental disorders using Research Diagnostic Criteria.

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  • Evaluation of patient impairment associated with mental disorders.
  • Analysis of different mental disorder types and their contribution to disability.

    • Main Results:

    • Approximately 30% of primary care patients have at least one mental disorder, with most being chronic (lasting >1 year).
    • Around 9% of patients experience some impairment, and 2% have severe impairment due to mental disorders.
    • Affective disorders are most common, but personality, psychotic, and anxiety disorders cause the greatest severe disability.

    Conclusions:

    • Chronic mental disorders are prevalent in primary care, often with significant functional impairment.
    • Primary care settings are critical for identifying and managing mental health conditions.
    • A multidisciplinary approach is needed to address the complex needs of chronically mentally ill patients in primary care.