ABSTRACT
BACKGROUND: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ). METHODS: Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ. RESULTS: The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P <0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49~82) in major depressive disorders, 70% (50~90) in panic disorders, 70% (56~83) in somatoform disorders, 84% (75~92) in alcohol abuse, and 68% (62~74) in any mental disorders. Patients' response to the PHQ was overall very receptive. CONCLUSION: One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.
Subject(s)
Humans , Alcoholism , Anxiety Disorders , Confidence Intervals , Depressive Disorder , Depressive Disorder, Major , Diagnosis , Feeding and Eating Disorders , Family Practice , Korea , Medical History Taking , Mental Disorders , Panic Disorder , Physicians, Family , Prevalence , Primary Health Care , Seoul , Somatoform Disorders , Surveys and QuestionnairesABSTRACT
BACKGROUND: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements. METHODS: The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis. RESULTS: Postmenopausal women had signifcantly lower BMD than premenopausal women(p<0.001). Age(r= 0.545, p<0.001), body mass index(r=0.264, p<0.01) and education(r=0.284, p<0.01) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD. CONCLUSION: We conclude that, among women, lumbar BMD is highier in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.