Clinician Support
The anxiety and depressive disorders are the commonest mental disorders and people with these disorders are often disabled. There are effective treatments for all these disorders, the problem is that even in the wealthy countries like the US, Canada, England or Australia, less than a quarter of sufferers get proven treatments. Clearly we need to do two things; help people to help themselves, and inform people so they can choose wisely if treatment is available.
St Vincent's Hospital has launched Climategp.tv , a Web Based patient education system for use by the patients of primary care physicians. There are modules for eight diseases - anxiety, arthritis, asthma, cancer, depression, diabetes, heart failure and incontinence. It is particularly strong in the anxiety disorders (GAD, panic/agoraphobia and social phobia) and in depression where there are five modules crafted to the needs of people of varying sex and age. Designed to improve the care of people with chronic diseases, it is congruent with the practice improvement payments and should lessen the load on the GP while increasing the health gain. We strongly recommend that you go to the website www.climategp.tv to explore this tool. It also provides continuing professional education courses approved by RACGP, RNZCGP and ACCRM.
This section on resources for clinicians contains the relevant chapters about each disorder from The Management of Mental Disorders. For a list of publications available from the shop (including the CBT manuals for most of the disorders) see the Shop tab above. Similarly, see the above tabs for relevant information on the WHO Composite International Diagnostic Interview and the Anxiety Disorders Clinic in Sydney.
The K10 symptom scale is used in the self help section of this webite, and is available at gpcare.org. It is a scale of psychological distress developed for use in epidemiological surveys. It is suitable for use as an outcome measure in people with anxiety and depressive disorders. It is reproduced below.
The 10 item scale has five response categories and the score is the sum of those responses. Scores range from 10 to 50. Eighty eight percent of the population score below 20, they are likely to be well. Ten percent of the population score between 20 and 29. One third of the people scoring 20-24 and two thirds of the people scoring 25-29 are likely to meet criteria for a current mental disorder and when they do, be mildly or moderately disabled. Four out of five people scoring 30 and above will meet criteria for a mental disorder and are likely to be severely disabled.
The scale was developed by R. Kessler, Health Care Policy, Harvard University, Boston (Kessler, Andrews et al 2002) and the normative data are from the Australian Survey of Mental Health and Well-being (Andrews and Slade 2001)- see the research page for the appropriate references and http://www.hcp.med.harvard.edu/ncs/k6_scales.php .
Edited by Gavin Andrews MD, UNSW, 2007
©2007 CRUfAD
