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D E Ford

Publications and source records attributed to D E Ford.

57 records · Page 4Linked to original sources

Depressive symptoms among general medical patients: prevalence and one-year outcome.

Using prospective data from the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area surveys, we examined the relationship of depressive symptoms among patients seen by general medical practitioners, with the subsequent development of major depressive disorder. The goals of the analysis were to determine 1) the 1-year psychiatric status of these individuals, and 2) to evaluate factors associated with the risk of major depressive disorder (MDD) or dysthymia. Between 1980 and 1984, collaborators of the NIMH Epidemiologic Catchment Area program recruited 18,571 adult participants after probability sampling of census tracts and households in five metropolitan areas. To assess the occurrence of psychiatric conditions over time, staff administered the Diagnostic Interview Schedule soon after sampling and again at follow-up 1 year later. For this analysis, the study sample was limited to respondents who reported seeing a general medical physician in the previous 6 months and who were free of current depressive disorder at the baseline interview. Overall, 41% of the general medical patients reported experiencing at least one depressive symptom in the past 6 months. Between 3 and 5% of the individuals with depressive symptoms developed MDD or dysthymia at the follow-up interview. Although individuals with depressed mood had a slightly higher estimated relative risk compared with individuals with vegetative, or nonvegetative (cognitive) depressive symptoms, no single classification of symptoms was appreciably more likely to signal MDD or dysthymia 1 year later. However, the risk of depression increased with the number of depressive symptoms reported.(ABSTRACT TRUNCATED AT 250 WORDS)

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An evidence-based interactive computer program to assist physicians in counseling smokers to quit.

Computerized expert systems offer the promise of increasing the frequency and efficiency of physician counseling of smokers to quit by collecting pertinent data and presenting it to physicians in a useful manner to guide and inform the counseling session. This article explores one such program that collects patient information, before the physician visit, that is pertinent to counseling smokers as described in the Agency for Health Care Policy and Research's Smoking Cessation Guidelines and supported in the medical literature. The program uses the information collected to produce two reports: one for the physician to use during the visit and the other for the patient as a means of supplementing and reinforcing the counseling message. Pilot data are presented from volunteers and primary care patients.

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The current practices of internists in prevention of residential fire injury.

Residential fires are a leading cause of unintentional injury in the United States. We completed a cross-sectional study in an urban internal medicine clinic to describe the patients' risk factors for fire injury and internists' current methods for addressing this health problem. We used a physician self-report survey (n = 301), patient interviews (n = 300), and chart reviews (n = 300) in the evaluation. Among physicians returning the questionnaire (70% response rate), more than 85% demonstrated reasonable knowledge of injury as a major health problem and relatively positive attitudes toward incorporating injury prevention into clinical practice. However, 62% of physicians reported "never" and 23% only "seldom" counseling patients about smoke detectors. Among patients attending the clinic, only 63% reported having a smoke detector in their home. Factors associated with not having a smoke detector through multivariate logistic analysis were black race (odds ratio [OR] = 4.3, confidence interval [CI] = 1.7, 10.6) and patient report that physician did not counsel about smoke detectors (OR = 2.38, Cl = 1.15, 4.90). Age younger than 65 (OR = 1.7, Cl = .93, 2.9) and alcohol abuse (OR 1.5, Cl = .92, 2.5) were borderline in their statistical significance. Eighteen percent of the patients reported being counseled by their physician about smoke detectors, although no documentation appeared in any of the charts. In addition, those patients with risk factors for fire injury did not report being counseled more often than their lower risk counterparts.(ABSTRACT TRUNCATED AT 250 WORDS)

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