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Primary care and the early phases of schizophrenia in the Czech Republic

Published online by Cambridge University Press:  11 April 2011

David Holub ,
Barbora Wenigová ,
Daniel Umbricht  and
Andor E. Simon
David Holub
Affiliation:
Charles University School of Medicine, Hradec Kràlové, (CzechRepublic)
Barbora Wenigová
Affiliation:
Centre for Mental Health Care Development, Prague (Czech Republic)
Daniel Umbricht
Affiliation:
Translational Medicine Neuroscience, Hoffmann-La Roche Ltd., Basel (Switzerland)
Andor E. Simon*
Affiliation:
Specialised Outpatient Clinic for Early Psychosis, Psychiatric Outpatient Services Bruderholz (Switzerland) University Hospital of Psychiatry, University of Bern, Bern (Switzerland)
*
Address for correspondence: Dr. A.E. Simon, Clinical and Research Consultant Psychiatrist Specialised Outpatient Clinic for Early Psychosis, Psychiatric Outpatient Services Bruderholz, 4101 Bruderholz (Switzerland). Fax: +41–61–4254546 E-mail: [email protected]
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Summary

Aim – To explore knowledge, treatment setting, attitudes and needs associated with patients in early phases of psychosis among general practitioners (GPs) in Prague, andto compare results with GPs from 6 countries participating in the International GP Study (IGPS) on Early Psychosis (Canada, Australia, New Zealand, England, Norway,Austria). Methods – Survey questionnaires were mailed to 648 GPs in the city of Prague. Results – The response rate was 19.9%. Prague GPs showed significantly lower diagnostic knowledge of early phases of psychosis compared to their international colleagues. They frequently indicated depression/anxiety and somatic complaints as early warnings of psychosis. They more often considered their behaviour to be problematic and more commonly handed them over to specialists. The majority of Prague GPs wished specialized outpatient services for low-threshold referrals of such patients. Conclusions – Along the mental health reforms in the Czech Republic which emphasis the role of primary care, GPs' knowledge of the early warning signs of psychosis needs to be improved.

Declaration of Interest: The study was supported by an unrestricted grant from Sanofi-Synthélabo SA, Switzerland, to the principal investigators of the IGPS (AES, DU). The authors have stated that there are none; all authors are independent from the funding body and the views expressed in this paper have not been influenced by the funding source.

Keywords

primary health caregeneral practitionersgeneralistearly psychosis.
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 19 , Issue 3 , September 2010 , pp. 243 - 250
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

Balicki, M., Leder, S. & Piotrowski, A. (2000). Focus on psychiatry in Poland. British Journal of Psychiatry 177, 375–381.CrossRefGoogle ScholarPubMed
Birchwood, M., Todd, P. & Jackson, C. (1998). Early Intervention in psychosis. British Journal of Psychiatry 172, 53–59.CrossRefGoogle ScholarPubMed
Boerma, W. G. W., Van der Zee, J. & Fleming, D. M. (1997). Service profiles of general practitioners in Europe. British Journal of General Practice 47, 481–486.Google ScholarPubMed
Edwards, J., McGorry, P. D. & Pennell, K. (2000). Models of early intervention in psychosis: an analysis of service approaches. In Early Intervention in Psychosis. A Guide to Concepts, Evidence and Interventions (ed. Birchwood, M., Fowler, D., Jackson, C.). Wiley: Chichester-Google Scholar
Füredi, J., Mohr, P., Swingler, D., Bitter, I., Gheorghe, M. D., Hotujac, L., Jarema, M., Kocmur, M., Koychev, G. I., Mosolov, S. N., Pecenak, J., Rybakowski, J., Svestka, J. & Sartorius, N. (2006). Psychiatry in selected countries of Central and Eastern Europe: an overview of the current situation. Acta Psychiatrica Scandinavica 114, 223–231.CrossRefGoogle ScholarPubMed
Grielen, S. J., Boerma, W. G. W. & Groenewegen, P. P. (2000). Unity or diversity? Task profiles of general practitioners in Central and Eastern Europe. European Journal of Public Health 10, 249–254.CrossRefGoogle Scholar
Häfner, H., Löffler, W., Maurer, K., Hambrecht, M. & an der Heiden, W. (1999). Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatrica Scandinavica 100, 105–118.Google Scholar
Jack, B., Nagy, Z. & Varga, Z. (1997). Health care reform in Central and Eastern Europe. European Journal of General Practice 3, 152–158.CrossRefGoogle Scholar
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, S., Chatterji, S., Lee, S., Ormel, J., Üstün, B., Wang, P. S. (2009). The global burden of mental disorders: An update from the WHOWorld Mental Health (WMH) Surveys. Epidemiologia e Psichiatria Sociale 18, 23–33.CrossRefGoogle Scholar
Kety, S. S. (1987). The significance of genetic factors in the etiology of schizophrenia: results from the national study of adoptees in Denmark. Journal of Psychiatry Research 21, 423–429.CrossRefGoogle ScholarPubMed
Krizova, E. & Simek, J. (2002). Rationing of expensive medical care in a transition country – nihil novum? Journal of Medical Ethics 28, 308–313.CrossRefGoogle Scholar
Larsen, T. K., Melle, I., Auestad, B., Friis, S., Haahr, U., Johannessen, J. O., Opjordsmoen, S., Rund, B. R., Simonsen, E., Vaglum, P. & McGlashan, T. (2006). Early detection of first-episode psychosis: the effect on 1-year outcome. Schizophrenia Bulletin 32, 758–764.CrossRefGoogle ScholarPubMed
Miller, T. J., McGlashan, T. H., Woods, S. W., Stein, K., Driesen, N., Corcoran, C. M., Hoffman, R. & Davidson, L. (1999). Symptom assessment in schizophrenic prodromal states. Psychiatry Quarterly 70, 273–287.CrossRefGoogle ScholarPubMed
Pawlowski, T. & Kiejna, A. (2004). Pathways to psychiatric care and reform of the public health care system in Poland. European Psychiatry 19, 168–171.CrossRefGoogle ScholarPubMed
Penn, D.L. & Corrigan, P.W. (2002). The effects of stereotype suppression on psychiatric stigma. Schizophrenia Research 55, 269–276.CrossRefGoogle ScholarPubMed
Platz, C., Umbricht, D., Cattapan-Ludewig, K., Dvorsky, D., Arbach, D., Brenner, H. D. & Simon, A. E. (2006). Help-seeking pathways in early psychosis. Social Psychiatry and Psychiatric Epidemiology 41, 967–974.CrossRefGoogle ScholarPubMed
Raboch, J. & Wenigová, B. (2005). Working Group of the Czech Psychiatric Association. Mental health care in Prague. European Psychiatry 20, S289–S293.CrossRefGoogle Scholar
Raiter, T., Alexandridu, A., De Beuckelearová, O., Lajka, J. & Wenigová B. (2004). Implementation of the Concept of Psychiatry from the perspective of outpatient services. Retrieved April 12, 2010, from www.cmhcd.cz\dokumenty\STEMMARKBariery_psychiatrie_zaverecna_zprava%20(2).pdfGoogle Scholar
Ricciardi, A., McAllister, V., Dazzan, P. (2008). Is early intervention in psychosis effective? Epidemiologia e Psichiatria Sociale 17, 227–235.CrossRefGoogle ScholarPubMed
Saxena, S. (2008). Use of clinical and service indicators to decrease the treatment gap for mental disorders: a global perspective. Epidemiologia e Psichiatria Sociale 17, 267–269.CrossRefGoogle ScholarPubMed
Simon, A. E., Lauber, C., Ludewig, K., Braun-Scharm, H. & Umbricht, D. S. (2005). General practitioners and schizophrenia: results from a Swiss survey. British Journal of Psychiatry 187, 274–281.CrossRefGoogle ScholarPubMed
Simon, A. E., Lester, H., Tait, L., Stip, E., Roy, P., Conrad, G., Hunt, J., Epstein, I., Larsen, T. K., Amminger, P., Holub, D., Wenigová, B., Turner, M., Berger, G. E., O'Donnell, C. & Umbricht, D. (2009). The International Study on General Practitioners and Early Psychosis (IGPS). Schizophrenia Research 108, 182–190.CrossRefGoogle Scholar
Skeate, A., Jackson, C., Birchwood, M. & Jones, C. (2002). Duration of untreated psychosis and pathways to care in first-episode psychosis. Investigation of help-seeking behaviour in primary care. British Journal of Psychiatry, Suppl. 43, 73–77.CrossRefGoogle ScholarPubMed
Thornicroft, G. (2008). Stigma and discrimination limit access to mental health care. Epidemiologia e Psichiatria Sociale 17, 14–19.CrossRefGoogle ScholarPubMed
Tomov, T. (2001). Mental health reforms in Eastern Europe. Acta Psychiatrica Scandinavica 104, Suppl. 410, 21–26.CrossRefGoogle Scholar
Tringer, L. (1999). Focus on psychiatry in Hungary. British Journal of Psychiatry 174, 81–85.CrossRefGoogle Scholar
Verdoux, H., Cougnard, A., Grolleau, S., Besson, R. & Delcroix, F. (2006). A survey of general practitioners' knowledge of symptoms and epidemiology of schizophrenia. European Psychiatry 21, 238–244.CrossRefGoogle ScholarPubMed
Wu, E. Q., Birnbaum, H. G., Shi, L., Ball, D. E., Kessler, R. C., Moulis, M. & Aggarwal, J. (2005). The economic burden of schizophrenia in the United States in 2002. Journal of Clinical Psychiatry 66, 1122–1129.CrossRefGoogle ScholarPubMed