Management of Current Psychiatric Disorders

Author:

Oude Engberink Agnés123,Carbonnel François123,David Michel123,Norton Joanna45,Bourrel Gérard23,Boulenger Jean-Philippe56,Capdevielle Delphine456

Affiliation:

1. Département de médecine générale, faculté de médecine, l’Université de Montpellier, Montpellier, France

2. Laboratoire Epsylon, EA4556 Dynamique des capacités humaines et des conduites de santé, l’Université de Montpellier, Montpellier, France

3. CEPS Platform, Université de Montpellier, Montpellier, France

4. Inserm U1061, Montpellier, France

5. Université de Montpellier, France

6. Service Universitaire de Psychiatrie Adulte Hôpital la Colombiére, Centre Hospitalier régional Universitaire (CHRU), Montpellier, France

Abstract

Objective: Describe and analyse the experience of family physicians in managing current psychiatric disorders to obtain a better understanding of the underlying reasons of under-detection and inadequate prescribing identified in studies. Methods: A qualitative study using in-depth interviews. Sample of 15 practicing family physicians, recruited by telephone from a precedent cohort (Sesame1) with a maximum variation: sex, age, single or group practice, urban or rural. Qualitative method is inspired by the completed grounded theory of a verbatim semiopragmatic analysis from 2 experts in this approach. Results: Family physicians found that current psychiatric disorders were related to psychological symptoms in reaction to life events. Their role was to make patients aware of a psychiatric symptom rather than establish a diagnosis. Their management responsibility was considered in contrasting ways: it was claimed or endured. They defined their position as facilitating compliance to psychiatrist consultations, while assuring a complementary psychotherapeutic approach. Prescribing medication was not a priority for them. Conclusions: The identified under-detection is essentially due to inherent frontline conditions and complexity of clinical forms. The family physician role, facilitating compliance to psychiatrist consultations while assuring a support psychotherapy is the main result of this study. More studies should be conducted to define more accurately the clinical reality, management and course of current psychiatric disorders in primary care.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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