Collaborative Care model in mental health. Scope and experiences after three years of activity in Mexico City

Valerio Villamil-Salcedo, B. E. Vargas-Terréz, A. Díaz-Anzaldúa
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引用次数: 5

Abstract

Aim The aim of this study was to evaluate the experience of the Collaborative Care model with general practitioners (GPs) for diagnosis and treatment of depression and anxiety disorders in primary care centers (PCC). Background For many years, different ways to address mental health problems in primary care settings have been evaluated. However, there is still debate over how to treat psychiatric conditions in such a context. Method A cross-sectional design was used. The study was conducted in two consecutive studies in six PCC that serve marginalized population in Mexico City. In the first study, cases were interviewed, diagnosed, and treated by a psychiatrist. In the second study, Collaborative Care model was used and GPs were trained; psychiatrists diagnosed and treated patients but GPs discussed the symptoms and treatment of the patients with the psychiatrist. Findings First study: 18 patients with depressive and/or anxiety disorders were interviewed; these cases were not discussed between the GPs and the psychiatrist. Second study: psychiatrists and GPs conducted joint interviews and cases were discussed. From the 399 evaluated individuals, 38.94% were diagnosed with a depressive disorder. After the Collaborative Care model was applied, GPs were more aware about mental health problems and they were more interested in the identification of these conditions in PCC. Replication studies will help confirm the effectiveness of this model.
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精神卫生的协同护理模式在墨西哥城三年活动后的范围和经验
目的本研究的目的是评估合作护理模式在初级保健中心(PCC)与全科医生(gp)诊断和治疗抑郁症和焦虑症的经验。多年来,人们对在初级保健机构中处理精神卫生问题的不同方法进行了评估。然而,在这种情况下如何治疗精神疾病仍然存在争议。方法采用横断面设计。这项研究是在墨西哥城为边缘人群服务的六个PCC中连续进行的两项研究。在第一项研究中,病例由精神病医生采访、诊断和治疗。第二项研究采用协同护理模式,对全科医生进行培训;精神科医生诊断和治疗病人,但全科医生与精神科医生讨论病人的症状和治疗方法。第一项研究:采访了18名患有抑郁症和/或焦虑症的患者;这些病例没有在全科医生和精神病医生之间进行讨论。第二项研究:精神科医生和全科医生进行联合访谈,并对病例进行讨论。在399名被评估的个体中,38.94%被诊断患有抑郁症。采用协同护理模式后,全科医生对心理健康问题的认识有所提高,对心理健康问题的识别也更感兴趣。复制研究将有助于确认该模型的有效性。
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