Abstract

DE LA GRECCA PREVOO, Robert; ZAPATA VEGA, María Isabel; VEGA DIENSTMAIER, Johann  and  MAZZOTTI, Guido. Care of patients with mental disorders in general medicals outpatient settings in three hospitals in Lima. Rev Med Hered [online]. 2005, vol.16, n.4, pp.246-252. ISSN 1018-130X.

The international literature reports different studies on the management of psychiatric disorders (PD) in non-psychiatric settings; however, in Peru the studies are basically focused on the prevalence of PD in general population or in non-psychiatric hospital settings. Objective: To collect information about characteristics and attitudes of General Practitioners (GPs) and patterns in managing patients with possible psychiatric disorders (PD). Material and methods: A survey was administered to 73 physicians working in general medical outpatient settings in three hospitals in Lima-Peru. Results: 23% of GPs received post-graduate psychiatry update courses, 56% felt confident in their ability to diagnose a patient with a PD, 82% reported interest in their medical management, and 66% felt capable of helping them. As their usual practice, 37% reported performing a mental status examination (MSE), 48% asking about sexual issues, and 37% about personal and family history of PD. Confidence in their diagnosis was significantly higher in male GPs and attendings, but interest in the management was higher in females. Post-graduate psychiatric update was significantly associated with confidence in diagnosing PD, asking about psychiatric history and sexual health, and performing MSE. Most frequently seen PD listed were: depression, unexplained somatic complaints, and anxiety disorders. Most frequently prescribed psychotropics listed were: hypnotics/sedatives; tonics, vitamins, and herbs; and antidepressants, particularly tricyclics. If a diagnosis of PD was made, 93% referred the patients to a psychiatrist. Conclusions: Factors related to the GPs may influence the patterns of care of psychiatric patients in primary care. (Rev Med Hered 2005;16:246-252).

Keywords : Mental disorders; health services; primary health care.

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