Integrating Bipolar Disorder Management in Primary Care

被引:30
作者
Kilbourne, Amy M. [1 ,2 ]
Goodrich, David E. [1 ,2 ]
O'Donnell, Allison N. [1 ]
Miller, Christopher J. [3 ]
机构
[1] VA Ann Arbor Ctr Clin Management Res, Ann Arbor, MI 48105 USA
[2] Univ Michigan, Sch Med, Dept Psychiat, Ann Arbor, MI USA
[3] VA Boston Healthcare Syst, Ctr Org Leadership & Management Res, Boston, MA USA
关键词
Bipolar disorder; Mood disorder; Co-occurring conditions; Primary care; Integrated care; Collaborative care; Chronic Care Model; CCM; Screening; Diagnosis; Treatment; Access; Mental health services; Psychiatry; TASK-FORCE RECOMMENDATIONS; ANXIETY TREATMENTS CANMAT; RANDOMIZED CONTROLLED-TRIAL; MAJOR DEPRESSIVE DISORDER; CANADIAN NETWORK; MOOD DISORDERS; SPECTRUM DISORDER; COMORBID ANXIETY; INTERNATIONAL SOCIETY; SCREENING INSTRUMENT;
D O I
10.1007/s11920-012-0325-4
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
There is growing realization that persons with bipolar disorder may exclusively be seen in primary (general medical) care settings, notably because of limited access to mental health care and stigma in seeking mental health treatment. At least two clinical practice guidelines for bipolar disorder recommend collaborative chronic care models (CCMs) to help integrate mental health care to better manage this illness. CCMs, which include provider guideline support, self-management support, care management, and measurement-based care, are well-established in primary care settings, and may help primary care practitioners manage bipolar disorder. However, further research is required to adapt CCMs to support complexities in diagnosing persons with bipolar disorder, and integrate decision-making processes regarding medication safety and tolerability in primary care. Additional implementation studies are also needed to adapt CCMs for persons with bipolar disorder in primary care, especially those seen in smaller practices with limited infrastructure and access to mental health care.
引用
收藏
页码:687 / 695
页数:9
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