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L Kebbon

Publications and source records attributed to L Kebbon.

4 recordsLinked to original sources

Mental health problems in primary health care as seen by doctors.

Mental health problems in primary health care are much more common than can be concluded by routine registration of diagnoses. This has been shown in a previous study by the authors in 1979. In order to test the consistency of these results (Study I) and the reliability of our method a replication was carried out in 1983 at the same health centre but with mainly other doctors (Study II). All visits to the health centre were studied during a period of four weeks. During the study period all doctors recorded mental health problems of importance for the visit in addition to the routine registration of diagnoses. The results of both studies showed a high degree of consistency. Mental health problems were observed in about 17% of the patients in both studies. Sex differences were similar: 20-21% of female patients and 14% of male patients had mental health problems. Psychiatric diagnoses were only registered in six per cent of patients in Study I and five per cent in Study II. Mental problems were especially common in connection with abdominal and chest disorders. The replication thus confirmed our previous findings that mental health problems are common in primary health care. Such problems should therefore be given more attention in the training of doctors in general practice.

Adult

Relation between criteria: case-finding method and prevalence.

In order to test some hypothesis of possible causes of different figures of prevalence reported for especially mild mental retardation ten Scandinavian studies 1961-1986 are reviewed, compared and critically analyzed. Theoretical definitions of mental retardation in these studies are found to correspond well. The operational procedures and measures used, in contrast, are much more heterogeneous and still more so the case-finding methods: sampling, screening or other identification procedures. It is concluded that case-finding methods are the most decisive factors for the resulting prevalence figures in epidemiological studies, especially concerning mild mental retardation. In an analogous way numbers of persons identified as mentally retarded within the special services (administratively classified by BPSMR) in different countries are determined by criteria for inclusion and social processes of different kinds.

Deinstitutionalization

Psychiatric symptoms and psychosocial problems in primary health care as seen by doctors.

All visits at a primary health care centre in Sweden were studied during four weeks. The frequency of psychiatric symptoms or psychosocial problems noted by the doctors was recorded on a special form in addition to routine registration of diagnoses. Such problems were noted in 553 out of 3 205 visits, corresponding to 17.3%. Considerable variation in registering problems was found between individual physicians and between different categories of doctors. The most common problems were nervousness, anxiety, psychosomatic disorders, and depression. Mental problems were especially common in connection with gastritis, precordial pain, and abdominal pain. There was a difference between the sexes: 20% of the female patients had mental problems registered compared with 14% of the male patients. Psychiatric diagnoses, however, were registered in only 6% of all cases. Of the 553 patients with mental problems, 16% were considered in need of a specialist, 52% could be dealt with at the health centre, and for 32% no special treatment for the mental problems was regarded necessary. One conclusion is that the routine registration of diagnoses at the health centre covers only some of the mental problems and is therefore insufficient in terms of planning psychiatric resources and the training of doctors. Possible reasons for the differences found are discussed.

Adolescent