Common Mental Disorders Depression - New Zealand Doctor

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Management of dementia in primary care It is beyond the scope of this guideline to address the management of dementia. A Royal Australian College of General Practitioners guideline on this topic can be found at http://www.racgp.org.au/guidelines/dementia. 542 118 Identification of Common Mental Disorders and Management of Depression in Primary Care
9 Models of care 9.1 Introduction Various models of service delivery have been proposed for the delivery of mental health services in primary care and for the configuration of primary care and secondary care mental health services. A narrative review was conducted of the relevant evidence, with a focus on New Zealand literature and special issues for Mäori and Pacific peoples. This review does not constitute guidance, but aims to provide an informative summary of issues and points to consider. 9.2 Generic models: evidence review A recent high-quality New Zealand Health Technology Assessment systematic review 339 reviewed nine systematic reviews and 35 randomised controlled trials (RCTs) on the structure and workforce configuration of effective models of mental health service provision and quality improvement in primary care, focusing on services for those with mild to moderate mental disorders. The following models were identified: • staff training: education of primary care staff (eg, on prescribing habits, skills in psychological therapies, dissemination of guidelines and information, intensive practice-based education seminars) • consultation-liaison: mental health specialist involvement in an ongoing educational relationship with primary care clinicians to enable them to care for individual patients. Referral to specialist care required in a small proportion of cases • collaborative care: includes new quasi-specialist staff (sometimes called case or care managers) who work with patients and liaise with both primary care clinicians and secondary care specialists in order to improve quality of care. This model may also involve screening, education of patients, changes in practice routines and developments in information technology • replacement/referral: primary responsibility for the management of the patient’s presenting problem is passed to a mental health specialist for the duration of treatment (eg, often associated with psychological therapy). Identification of Common Mental Disorders and Management of Depression in Primary Care 119
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Identification of Common Mental Dis
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Statement of intent Evidence-based
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Endorsements Te Ao Maramatanga New
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3.6 Clinical features of common men
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List of figures 3.1 When to refer a
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About the guideline Foreword The Ne
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About the guideline Guideline devel
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About the guideline Paediatric subg
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About the guideline Royal New Zeala
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Algorithm 1 Management of depressio
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Algorithm 2a Management of severe d
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Algorithm 2c Management of mild dep
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• limited access to psychiatrists
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Asian peoples About 7% of the New Z
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12-month period amongst adults atte
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Table 1.2 Prevalence of common ment
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1.4 Etiology of common mental disor
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The ‘hopelessness theory’ 94 co
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Sexuality Data from the Christchurc
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Since those who are affected by sui
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2.3 Managing depression: the steppe
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to informed consent. 152 There is a
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3 Recognition and assessment of com
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Chapter 3 Recognition and assessmen
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Good practice points Management of
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Box 4.1 Whänau Ora The concept of
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If the young person/rangatahi/tamar
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Exercise There was insufficient evi
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at any timepoint. Treatment as usua
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5 Recognition and assessment of com
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Page 93 and 94: 6 Management of depression in adult
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Page 118 and 119: Recommendations continued... Women
Page 120 and 121: during pregnancy, of which up to 6%
Page 122 and 123: Secondary care evidence Based on ev
Page 124 and 125: Advice for women It may be helpful
Page 126 and 127: Social networks appear to be an inf
Page 128 and 129: eastfeeding, or not breastfeeding,
Page 130 and 131: This evidence comprised two recent
Page 132 and 133: There is also some evidence that th
Page 135 and 136: 8 Special issues: older adults/ kor
Page 137 and 138: Chapter 8 Special issues: older adu
Page 143: Chapter 8 Special issues: older adu
Page 147 and 148: Chapter 9 Models of care were reduc
Page 149 and 150: Chapter 9 Models of care • networ
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Page 154 and 155: Quality improvement collaboratives
Page 156 and 157: NZGG has been funded to develop sum
Page 158 and 159: Appendix A: Guideline development p
Page 160 and 161: Appendix B: Evidence and recommenda
Page 162 and 163: Appendix C: Assessment of suicide r
Page 164 and 165: Appendix D: Assessment tools for co
Page 166 and 167: Anxiety Anxiety is often comorbid w
Page 168 and 169: Appendix F: Self-management resourc
Page 170 and 171: Information about mental disorders
Page 172 and 173: Dysthymia Dysthymia is a chronic lo
Page 175 and 176: Glossary, abbreviations and acronym
Page 181 and 182: References 1. The MaGPIe Research G
Page 183 and 184: References 38. Tse S, Tong K, Hong
Page 185 and 186: References 72. Kendler K, Kuhn J, P
Page 187 and 188: References 107. Halligan SL, Murray
Page 189 and 190: References 143. Dejesus RS, Vickers
Page 191 and 192: References 179. Shaffer D, Scott M,
Page 193 and 194: References 215. Garralda ME, Bowman
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References 249. Zwaanswijk M, Verha
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References 283. Linde K, Berner M,
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References 318. Henkel V, Mergl R,
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References 353. Rush AJ. STAR*D: wh
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References 386. Ward E, King M, Llo
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References 417. Kirsch I, Deacon BJ
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References 451. Zigmond AS, Snaith
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References 486. Appleby L, Warner R
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References 520. Irwin M, Artin KH,
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References 557. Agnew F, Pulotu-End
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www.nzgg.co.nz www.moh.govt.nz
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Common Mental Disorders Depression - New Zealand Doctor

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