New thesis about different aspects of common mental disorders in primary care
Hi Sandra af Winklerfelt Hammarberg, PhD student at the Division of Family Medicine and Primary Care. On February 17 you will defend your thesis "Aspects of common mental disorders in primary care" what is the main focus of the thesis?
Patients with common mental disorders are a large group in primary care where there are uncertainties about diagnosis and symptom related to sick leave (Study I); the effectiveness of a strengthened care coordination with care managers for patients with depression in the long term (Study II) and how these care managers affect the GPs’ work (Study III). Patients with generalized anxiety disorder constitute a large group of patients, often with great and long-term suffering, where there is a lack of knowledge about which psychological treatments can be given and what effect they have in primary care (Study IV).
Which are the most important results?
In structured psychiatric interviews, many patients on sick leave for common mental disorders met criteria for diagnoses other than the one on their sick leave certificate. Patients who met the Swedish criteria for stress-induced exhaustion disorder and those with the most severe symptoms were on sick leave the longest (Study I). Patients with care managers for depression had less severe symptoms, higher quality of life and higher trust in care even 12 to 24 months after the intervention compared to usual care (Study II). The GPs had different experiences of working with care managers, and they emphasized the need to clarify care managers’ role in the care team (Study III). It was feasible to conduct a study comparing two different cognitive behavioral therapies for patients with generalized anxiety disorder in primary care. Both therapies had large effects on reducing worry, which were maintained six months later, but metacognitive therapy appeared to have even better effects on recovery compared to intolerance-to-uncertainty therapy.
How can this new knowledge contribute to the improvement of people’s health?
With better knowledge and understanding about the diagnoses and symptoms related to sick leave, the role of care managers in supporting patients with common mental disorders, and the psychological treatments for patients with generalized anxiety disorder in primary care, we can hopefully develop and spread methods to help more patients with common mental disorders in primary care.
What´s in the future for you? Will you keep on conducting research?
I will continue as head of and GP at Liljeholmen Academic Primary Care Center, trying to develop and strengthen patient-oriented research in primary care. I will continue research in the field of common mental disorders in primary care together with the developing research groups.