Biomedical subjects
Publications and source records attributed to Grant Blashki.
OBJECTIVE: To assist psychiatrists who work closely with general practitioners (GPs) at the primary/secondary care interface. CONCLUSION: The role of primary care psychiatrists can be enhanced by a sound appreciation of the general practice context, knowledge of the local mental health services and an understanding of the educational and clinical support needs of GPs.
BACKGROUND: Australian general practitioners are often the first point of call for people seeking mental health care including those from culturally and linguistically diverse (CALD) backgrounds, some of whom may be more at risk of having a mental illness but are failing to access the appropriate mental health care. OBJECTIVE: This article is intended to assist GPs in the recognition, diagnosis and management of mental illness in patients from CALD backgrounds by providing current research evidence and presenting some practical recommendations. More attention is paid to the larger CALD populations such as the southern European and Asian communities, and does not deal with indigenous Australians. DISCUSSION: There is an increasing call for GPs to have a key role in the detection, diagnosis and management of mental illness, including for patients from CALD backgrounds. Effective care requires that GPs are aware of, and understand how culture may influence recognition, diagnosis and management of mental illness in this group of patients.
BACKGROUND: Panic disorder (PD) is common in the community and contributes to significant distress and decreased quality of life for people who suffer from it. Most people with PD will present in the first instance to their general practitioner or hospital emergency department for assistance, often with a focus on somatic symptoms and concerns. OBJECTIVE: This article aims to assist the GP to manage this group of patients by providing an outline of aetiology, approaches to assessment, and common management strategies. DISCUSSION Although GPs have an important role to play in ruling out any causal organic basis for panic symptoms, the diagnosis of PD can usually be made as a positive diagnosis on the basis of careful history taking. Thorough and empathic education is a vital step in management. The prognosis for PD can be improved by lifestyle changes, specific psychological techniques, and the judicious use of pharmacotherapy.
BACKGROUND: The lifetime risk of schizophrenia is about one in 100. It is an illness associated with substantial disability and increased risk of physical illness. OBJECTIVE: This article updates general practitioners on the physical, psychological and social management of patients with schizophrenia. DISCUSSION: General practitioners have a key role in managing patients with schizophrenia, including early detection of prodromal symptoms, monitoring and preventing relapses, and providing high quality primary and secondary prevention for common physical problems. Effective care requires a thorough understanding of local specialist services, pharmacotherapies, and familiarity with psychosocial interventions that will genuinely benefit patients.
OBJECTIVE: To investigate Australian general practitioners' experiences of accessing education about depression and their preferences for future education on depression and related disorders. METHOD: Six hundred and eight anonymous surveys were distributed to GPs through 52 rural and urban divisions of general practice; 420 were returned. RESULTS: Educational formats involving direct contact with people having mental health expertise were highly valued. Distance education and web based technologies were least used. In the previous year, women and older GPs had spent more time on education about depression. Most intended to undertake more such education in the future and said that education in psychosocial strategies would be very useful. General practitioners' attitudes to further education about depression were influenced by their gender, practice location, and their previous mental health training. DISCUSSION: More face-to-face training may be desirable to take advantage of GPs' willingness to spend more time on education about depression and related disorders.
BACKGROUND: Children with anxiety, attention deficit hyperactivity, and disruptive behaviour disorders are frequently seen in general practice and often present with somatic complaints, comorbidity and complex family relationships. OBJECTIVE: This article presents an approach to assessment including useful clinical questions, case diagnostic criteria and recommendations on psychometric tools for general practice. DISCUSSION: Key management principles including psychological and pharmacological approaches are outlined, and a multidisciplinary approach incorporating specialist care is recommended.
Provision of "Focussed Psychological Strategies" by general practitioners is one component of the recent Better Outcomes in Mental Health Care (BOiMHC) initiative. The BOiMHC initiative requires GPs to undertake minimum training requirements before they may provide services under the new Medicare Benefits Schedule item number. We argue that GPs need further training and ongoing clinical interaction with mental health specialists (beyond the minimum training requirements) for refinement of psychological skills. Research focusing on GP training and how GPs interact with specialist services in the provision of psychological treatments is urgently required.
BACKGROUND: Patients who present to primary care with symptoms of fainting and dizziness, for which there is no adequate physical explanation, are frequently suffering from an undiagnosed psychiatric disorder. OBJECTIVE: This article aims to improve the recognition of common mental disorders presenting as 'fits, faints and funny turns' (FFFTs) and to encourage general practitioners to view these disorders as a positive diagnosis in need of treatment. DISCUSSION: Psychiatric disorders, particularly panic attacks and depression, are common in the setting of FFFTs and should be a positive diagnosis rather than a diagnosis of exclusion. A detailed description of the episode, with corroborating information from a witness if possible, and psychiatric rating scales can assist in this process. Identifying a physical cause for the episode does not exclude a psychiatric diagnosis and vice versa. Specific psychological and pharmacological therapies are effective for anxiety and depression.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
BACKGROUND: The General Practice Psychiatry Program is a collaborative initiative between two universities and two professional colleges. Since 1998 it has offered general practitioners a one year part time Graduate Certificate, and a two year Master of General Practice Psychiatry. The learning is by distance education and multimode, including text packages sent out, tapes, teleconferences and two annual residential weekends with role plays and didactic teaching. OBJECTIVE: To describe the development of a Graduate Certificate and Master in General Practice Psychiatry. DISCUSSION: The program has been well supported with 141 general practitioners enrolling in the Graduate Certificate and 48 in the Masters during 1998-2001. General practitioners have been enrolling from around Australia, with rural, female and more experienced GPs predominating.
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