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S Kerry

Publications and source records attributed to S Kerry.

25 records · Page 2Linked to original sources

How does the content of consultations affect the recognition by general practitioners of major depression in women?

BACKGROUND: Major depression is a common and disabling condition. However, for many reasons, the condition is not recognized in about half of the patients with major depression. AIM: The aim of the study was to establish whether the content of general practice consultations affected general practitioners' recognition of major depressive illness in women patients. METHOD: The 30-item general health questionnaire was used as a first stage screening instrument for psychiatric morbidity. Patients newly recognized as depressed by their general practitioner and those not recognized as depressed who scored 11 or more on the questionnaire were interviewed, usually within three days of consulting their general practitioner, using the combined psychiatric interview. Videorecordings of the consultations for these two groups of women were analysed; analyses were based on mentions of physical, psychiatric and social symptoms and on whether the first mention of a psychiatric symptom was within the first four mentions of any symptoms (early in the consultation) or after four mentions of any symptoms (late) or if psychiatric symptoms were not mentioned. RESULTS: A paired sample of 72 women with major depression was obtained from patients consulting 36 general practitioners, each general practitioner providing one patient whom he or she had correctly recognized as being depressed and one patient whose depression had not been recognized. Women with major depression were about five times more likely to have their depression recognized if they mentioned their psychiatric symptoms early in the consultation compared with those who either left it later to mention such symptoms or never mentioned them. Major depression was more likely to be recognized if no physical illness was present. After adjusting for physical illness, depression was 10 times less likely to be recognized if the first psychiatric symptom was mentioned late in the consultation, or not mentioned at all, than if it was mentioned early in the consultation. CONCLUSION: General practitioners need to remember that patients who present with symptoms of physical illness may also have depression. They also need to remember to give equal importance diagnostically to mentions of symptoms at whatever point they occur in the consultation, regardless of the presence or absence of physical illness.

Adolescent↗

Patient characteristics associated with the labelling of asthma.

Patient characteristics associated with the asthma label were investigated in 262 children, aged 8 years, who reported wheezing illness in the previous 12 months. Children were first identified by a screening questionnaire administered to the parents of all 8 year old schoolchildren in Croydon, south London. Interviews were conducted with those reported to have had a wheezing illness in the previous 12 months to obtain details of the child's illness, medical care, demographic and socioeconomic characteristics. Multivariate analysis showed that the likelihood of being labelled asthmatic was increased in those who had a parental history of hayfever [odds ratio (OR) = 2.24, 95% confidence interval (CI) = 1.22-4.14] or at least two allergic provoking factors (OR = 3.83, 95% CI = 1.44-10.15). No significant associations were found between asthma labelling and children's socioeconomic characteristics or use of general practitioner services. These findings suggest that wheeze is likely to be labelled asthma when the clinical history suggests an allergic aetiology.

Asthma↗

Relationship between smoking, weight and attitudes to weight in adolescent schoolgirls.

A total of 1,932 schoolgirls aged 11-18 from seven schools in the South London area were surveyed using questionnaires which addressed eating patterns, body weight history, attitudes to body weight and shape, menstrual history and current smoking behaviour. They were also weighed and their height was measured. Twelve per cent of the girls were regular smokers and 10% smoked seven or more cigarettes over a 4 day period. Amongst girls aged 14 and over, 15% smoked regularly and a further 9% occasionally. A significant relationship was found between smoking and weight. Smokers were more likely to be moderately overweight in relation to their peers and to have been worried about their weight at some stage. There were differences between girls in state schools and those in independent schools with regard to smoking behaviour and weight. The findings have implications for anti-smoking strategies and health education generally.

Adolescent↗

Why do general practitioners recognize major depression in one woman patient yet miss it in another?

The aim of this study was to establish whether psychiatric patient characteristics and the presence of physical illness affected general practitioners' recognition of major depressive illness in women patients. The 30-item general health questionnaire was used as a first stage screening instrument for psychiatric morbidity and each patient selected was interviewed, usually within three days of consulting their general practitioner, using the combined clinical interview. A sample of 72 women with major depressive disorder was obtained from patients consulting 36 general practitioners mainly from the south west Thames region of England, each general practitioner providing one patient he or she had correctly recognized as being depressed and one patient whose depression had not been recognized. Few differences were found between the groups with recognized and unrecognized depression in their psychiatric or physical features. More patients with unrecognized depression experienced physical illness and were tired. Patients with serious physical disease were five times more likely not to be recognized as depressed than those without physical disease. Patients with recognized depression described a more distinct quality to their depressed mood. Women with unrecognized major depression are similar to those women whose major depression is recognized by their general practitioner. These findings require further elaboration by process and content analysis of the women's consultations.

Adolescent↗