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1.
Epidemiol Psichiatr Soc ; 19(3): 243-50, 2010.
Article in English | MEDLINE | ID: mdl-21261220

ABSTRACT

AIM: To explore knowledge, treatment setting, attitudes and needs associated with patients in early phases of psychosis among general practitioners (GPs) in Prague, and to compare results with GPs from 6 countries participating in the International GP Study (IGPS) on Early Psychosis (Canada, Australia, New Zealand, England, Norway, Austria). METHODS: Survey questionnaires were mailed to 648 GPs in the city of Prague. RESULTS: The response rate was 19.9%. Prague GPs showed significantly lower diagnostic knowledge of early phases of psychosis compared to their international colleagues. They frequently indicated depression/anxiety and somatic complaints as early warnings of psychosis. They more often considered their behaviour to be problematic and more commonly handed them over to specialists. The majority of Prague GPs wished specialized outpatient services for low-threshold referrals of such patients. CONCLUSIONS: Along the mental health reforms in the Czech Republic which emphasis the role of primary care, GPs' knowledge of the early warning signs of psychosis needs to be improved.


Subject(s)
Health Knowledge, Attitudes, Practice , Schizophrenia/diagnosis , Czech Republic , Early Diagnosis , Female , Humans , Male , Middle Aged , Primary Health Care
2.
Schizophr Res ; 108(1-3): 182-90, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19087897

ABSTRACT

BACKGROUND: In much of the world, general practitioners (GPs) are the health professionals most frequently initially contacted when a young person is developing psychosis. However little is known about their expertise in assessing psychosis and its risk. METHODS: To assess the diagnostic patterns and treatment practices related to psychosis of GPs working in a range of health care systems, questionnaires were mailed to 12,516 randomly selected GPs in seven countries: Canada, Australia, New Zealand, England, Norway, Austria and the Czech Republic. Sites were defined as gatekeeping or non-gatekeeping, based on the primary care health system in effect at each site. A gatekeeping system (GK) is one which mandates that patients see a GP before in order to be referred to a specialist. By contrast, in a non-gatekeeping (nGK) system, individuals can seek help directly from specialists without authorization by a GP. RESULTS: Twenty-two percent (n=2784) GPs responded to the mailed questionnaire. They reported low prevalence of early psychosis seen in general practice. Using awareness of functional decline as a prognostic sign as a proxy, gatekeeping (GK) GPs were found to be superior in their knowledge of the signs and symptoms of early psychosis than were non-gatekeeping GPs. GP's with less knowledge as to early psychosis were more likely to refer individuals with suspected psychosis to specialists. GP's reported a preference for access to specialized outpatient services as compared with obtaining continuous medical education relevant to early psychosis. The duration of maintenance treatment recommended by GP's was less than that recommended in international guidelines. GP's also underestimated the risk for relapse after a first episode of psychosis. CONCLUSIONS: As GPs were largely unaware of features of early psychosis, such as functional decline, this should be the target of educational programs for GP's. However, the incidence of psychosis is low and GP's express a preference for access to appropriate referral over continuing medical education. Therefore, the development of specialized services for the assessment and care of patients who are in the early stages of developing schizophrenia may be warranted.


Subject(s)
International Cooperation , Physician-Patient Relations , Physicians, Family/statistics & numerical data , Practice Patterns, Physicians' , Psychotic Disorders/diagnosis , Adult , Female , Humans , Male , Middle Aged , Surveys and Questionnaires
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