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Screening for Behavioral Health Problems in Adult Primary Care

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Behavioral Medicine and Integrated Care

Abstract

While clinical systems are adopting models of integrated primary care (IPC) at high rates, the scientific foundation for common IPC practices remains underdeveloped. In order for IPC to be successful both clinically and financially, multidisciplinary teams must be able to efficiently and effectively identify patients who would benefit from behavioral healthcare within the primary care service. To do so requires tactical broad and specific screening at both the population level and for those patients who are already known to be at risk for psychological and/or other behavioral health concerns. This chapter provides suggestions for screening practices to be utilized in adult IPC to assess for general behavioral health concerns as well as high prevalence specific clinical presentations.

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References

  • Aertgeerts, B., Buntinx, F., & Kester, A. (2004). The value of the CAGE in screening for alcohol abuse and alcohol dependence in general clinical populations: A diagnostic meta-analysis. Journal of Clinical Epidemiology, 57(1), 30–39.

    Article  Google Scholar 

  • Akincigil, A., & Matthews, E. B. (2017). National rates and patterns of depression screening in primary care: results from 2012 and 2013. Psychiatric Services, 68(7), 660–666.

    Article  Google Scholar 

  • Alschuler, K. N., Hoodin, F., & Byrd, M. R. (2009). Rapid assessment for psychopathology in a college health clinic: Utility of college student specific questions. Journal of American College Health, 58(2), 177–179.

    Article  Google Scholar 

  • Baumann, C., Erpelding, M. L., Perret-Guillaume, C., Gautier, A., Régat, S., Collin, J. F., … Briançon, S. (2011). Health-related quality of life in French adolescents and adults: Norms for the DUKE Health Profile. BMC Public Health, 11(1), 1–16.

    Article  Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Article  Google Scholar 

  • Bonnaud-Antignac, A., Hardouin, J. B., Leger, J., Dravet, F., & Sebille, V. (2012). Quality of life and coping of women treated for breast cancer and their caregiver. What are the interactions? Journal of Clinical Psychology in Medical Settings, 19(3), 320–328.

    Article  Google Scholar 

  • Byrd, M. R., & Alschuler, K. N. (2009). Behavioral screening in adult primary care. In L. C. James & W. T. O’Donohue (Eds.), The primary care toolkit: Practiced resources for the integrated behavioral care provider (pp. 121–130). New York: Springer.

    Google Scholar 

  • Centers for Disease Control and Injury Prevention (CDC). (2016). Data & statistics fatal injury report for 2016.

    Google Scholar 

  • deGruy, F. (1995). Mental diagnoses in primary care: The next generation. Archives of Family Medicine, 4, 208–210.

    Article  Google Scholar 

  • El-Rufaie, O. E., & Daradkeh, T. K. (1996). Validation of the Arabic versions of the thirty-and twelve-item General Health Questionnaires in primary care patients. The British Journal of Psychiatry, 169(5), 662–664.

    Article  Google Scholar 

  • Ewing, J. A. (1984). Detecting alcoholism: the CAGE questionnaire. JAMA, 252(14), 1905–1907.

    Article  Google Scholar 

  • Fontanesi, F., Gobetti, C., Zimmermann-Tansella, C., & Tansella, M. (1985). Validity of the Italian version of the General Health Questionnaire in a general practice setting. Psychological Medicine, 15, 411–415.

    Article  Google Scholar 

  • Garyfallos, G., Karastergiou, A., Adamopoulou, A., Moutzoukis, C., Alagiozidou, E., Mala, D., & Garyfallos, A. (1991). Greek version of the General Health Questionnaire: accuracy of translation and validity. Acta Psychiatrica Scandinavica, 84(4), 371–378.

    Article  Google Scholar 

  • Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9(1), 139–145.

    Article  Google Scholar 

  • Goldberg, D. P., & Williams, P. (1988). A User’s Guide to the General Health Questionnaire: GHQ. GL assessment.

    Google Scholar 

  • Goldberg, L. R. (1992). The development of markers for the Big-Five factor structure. Psychological Assessment, 4(1), 26.

    Article  Google Scholar 

  • Hart, P. D., Kang, M., Weatherby, N. L., Lee, Y. S., & Brinthaupt, T. M. (2015). Systematic review of health-related quality of life assessments in physical activity research. World Journal of Preventive Medicine, 3(2), 28–39.

    Google Scholar 

  • Hunter, C., Goodie, J., Oordt, M., & Dobmeyer, A. (2017). Integrated behavioral health in primary care: Step-bystep guidance for assessment and intervention. In C. Hunter, J. Goodie, M. Oordt, & A. Dobmeyer (Eds.), (2nd ed.). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Jackson, M. C. (2007). Systems approaches to management. Springer Science & Business Media.

    Google Scholar 

  • Kamimura, A., Christensen, N., Myers, K., Nourian, M. M., Ashby, J., Greenwood, J. L., & Reel, J. J. (2014). Health and diabetes self-efficacy: A study of diabetic and non-diabetic free clinic patients and family members. Journal of Community Health, 39(4), 783–791.

    Article  Google Scholar 

  • Kopta, S. M., & Lowry, J. L. (2002). Psychometric evaluation of the Behavioral Health Questionnaire-20: A brief instrument for assessing global mental health and the three phases of psychotherapy outcome. Psychotherapy Research, 12(4), 413–426.

    Article  Google Scholar 

  • Kroenke, K., Spitzer, R. L., Williams, J. B., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359.

    Article  Google Scholar 

  • Kung, S., Alarcon, R. D., Williams, M. D., Poppe, K. A., Moore, M. J., & Frye, M. A. (2013). Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) depression measures in an integrated mood disorders practice. Journal of Affective Disorders, 145(3), 341–343.

    Article  Google Scholar 

  • Lim, S. S., Vos, T., Flaxman, A. D., Danaei, G., Shibuya, K., Adair-Rohani, H., … Memish, Z. A. (2012). A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet, 380(9859), 2224–2260.

    Article  Google Scholar 

  • Maruish, M. E. (Ed.). (2017). Handbook of psychological assessment in primary care settings. Taylor & Francis.

    Google Scholar 

  • Mitchell, A. J., Meader, N., Bird, V., & Rizzo, M. (2012). Clinical recognition and recording of alcohol disorders by clinicians in primary and secondary care: Meta-analysis. The British Journal of Psychiatry, 201(2), 93–100.

    Article  Google Scholar 

  • Molina, J.G., Rodrigo, M.F., Losilla, J.M., & Vives, J. (2014). Wording effects and the factor structure of the 12-item General Health Questionnaire. Psychological Assessment, 26(3):1031-7. https://doi.org/10.1037/a0036472. Epub 2014 Apr 7.

    Article  Google Scholar 

  • Montazeri, A., Vahdaninia, M., Ebrahimi, M., & Jarvandi, S. (2003). The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version. Health and Quality of Life Outcomes, 1(1), 14.

    Article  Google Scholar 

  • Moriarty, A. S., Gilbody, S., McMillan, D., & Manea, L. (2015). Screening and case finding for major depressive disorder using the Patient Health Questionnaire (PHQ-9): A meta-analysis. General Hospital Psychiatry, 37(6), 567–576.

    Article  Google Scholar 

  • Muntingh, A. D., De Heer, E. W., Van Marwijk, H. W., Adèr, H. J., Van Balkom, A. J., Spinhoven, P., & Van der Feltz-Cornelis, C. M. (2013). Screening high-risk patients and assisting in diagnosing anxiety in primary care: The Patient Health Questionnaire evaluated. BMC Psychiatry, 13(1), 192.

    Article  Google Scholar 

  • Olfson, M., Marcus, S. C., Druss, B., Elinson, L., Tanielian, T., & Pincus, H. A. (2002). Nataional trends in the outpatient treatment of depression. Journal of the American Medical Association, 287, 203–209.

    Article  Google Scholar 

  • Parkerson, G. R., Jr., Broadhead, W. E., & Tse, C. K. J. (1990). The Duke Health Profile: A 17-item measure of health and dysfunction. Medical Care, 28, 1056–1072.

    Article  Google Scholar 

  • Perret-Guillaume, C., Briancon, S., Guillemin, F., Wahl, D., Empereur, F., & Thi, P. N. (2010). Which generic health related quality of life questionnaire should be used in older inpatients: Comparison of the duke health profile and the MOS short-form SF-36? The Journal of Nutrition, Health & Aging, 14(4), 325–331.

    Article  Google Scholar 

  • Pilowsky, D. J., & Wu, L. T. (2012). Screening for alcohol and drug use disorders among adults in primary care: A review. Substance Abuse and Rehabilitation, 3(1), 25–34.

    PubMed  PubMed Central  Google Scholar 

  • Pleis, J. R., & Lethbridge-Cejku, M. (2007). Summary health statistics for U.S. adults: National Health Interview Survey, 2006. Vital Health Statistics. Series 10, (235), 1–153.

    Google Scholar 

  • Prisnie, J. C., Fiest, K. M., Coutts, S. B., Patten, S. B., Atta, C. A., Blaikie, L., … Jetté, N. (2016). Validating screening tools for depression in stroke and transient ischemic attack patients. The International Journal of Psychiatry in Medicine, 51(3), 262–277.

    Article  Google Scholar 

  • Randall, J. M., Voth, R., Burnett, E., Bazhenova, L., & Bardwell, W. A. (2013). Clinic-based depression screening in lung cancer patients using the PHQ-2 and PHQ-9 depression questionnaires: A pilot study. Supportive Care in Cancer, 21(5), 1503–1507.

    Article  Google Scholar 

  • Rapin, A., Dramé, M., Jolly, D., Novella, J., Mahmoudi, R., Toussaint-Thorin, M., & Boyer, F. C. (2016). Psychometric properties of the Duke Health Profile in a neuromuscular disease population. European Journal of Physical and Rehabilitation Medicine, 52(1), 57–64.

    PubMed  Google Scholar 

  • Regier, D. A., Narrow, W. E., Rae, D. S., Manderscheid, R. W., Locke, B. Z., & Goodwin, F. K. (1993). The de Facto US mental and addictive disorders service system. Archives of General Psychiatry, 50(2), 85. https://doi.org/10.1001/archpsyc.1993.01820140007001

    Article  Google Scholar 

  • Scott, K., & Lewis, C. C. (2015). Using measurement-based care to enhance any treatment. Cognitive and Behavioral Practice, 22(1), 49–59.

    Article  Google Scholar 

  • Sidebottom, A. C., Harrison, P. A., Godecker, A., & Kim, H. (2012). Validation of the Patient Health Questionnaire (PHQ)-9 for prenatal depression screening. Archives of Women’s Mental Health, 15(5), 367–374. https://doi.org/10.1007/s00737-012-0295

    Article  PubMed  Google Scholar 

  • Segopolo, M. T., Selemogwe, M. M., Plattner, I. E., Ketlogetswe, N., & Feinstein, A. (2009). A screening instrument for psychological distress in Botswana: validation of the Setswana version of the 28-item General Health Questionnaire. International Journal of Social Psychiatry, 55(2), 149–156.

    Article  Google Scholar 

  • Spitzer, R. L., Kroenke, K., Williams, J. B., & Patient Health Questionnaire Primary Care Study Group. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282(18), 1737–1744.

    Article  Google Scholar 

  • Substance Abuse and Mental Health Services Administration (SAMHSA); National Survey on Drug Use and Health (NSDUH). (2015). Table 5.6B—Substance use disorder in past year among persons aged 18 or older, by Demographic Characteristics: Percentages, 2014 and 2015. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab5-6b. Accessed 18 Jan 2017.

  • Tran, P. L., Blizzard, C. L., Srikanth, V., Hanh, V. T., Lien, N. T., Thang, N. H., & Gall, S. L. (2015). Health-related quality of life after stroke: Reliability and validity of the Duke Health Profile for use in Vietnam. Quality of Life Research, 24(11), 2807–2814.

    Article  Google Scholar 

  • Vogel, M. E., Malcore, S. A., Illes, R. A. C., & Kirkpatrick, H. A. (2014). Integrated primary care: Why you should care and how to get started. Journal of Mental Health Counseling, 36(2), 130–144.

    Article  Google Scholar 

  • Wald, N. (2001). The definition of screening. Journal of Medical Screening, 8(1), 1.

    Article  Google Scholar 

  • Wang, P., Liou, S. R., & Cheng, C. Y. (2013). Prediction of maternal quality of life on preterm birth and low birthweight: A longitudinal study. BMC Pregnancy and Childbirth, 13(1), 124.

    Article  Google Scholar 

  • Wang, P. S., Demler, O., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2006). Changing profile of service sectors used for mental health care in the U.S. American Journal of Psychiatry, 163(7), 1187–1198.

    Article  Google Scholar 

  • Wang, P. S., Lane, M., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005). Twelve-month service use of mental health services in the United States. Archives of General Psychiatry, 62, 629–640.

    Article  Google Scholar 

  • Werneke, U., Goldberg, D. P., Yalcin, I., & Ãœstün, B. T. (2000). The stability of the factor structure of the General Health Questionnaire. Psychological Medicine, 30(4), 823–829.

    Article  Google Scholar 

  • World Health Organization (WHO). (2015). Alcohol. Available at: http://www.who.int/mediacentre/factsheets/fs349/en/# (link is external). Accessed 19 Sept 2016.

  • Young, A. S., Klap, R., Sherbourne, C. D., & Wells, K. B. (2001). The quality of care for depressive and anxiety disorders in the United States. Archives of General Psychiatry, 58(1), 55–61.

    Article  Google Scholar 

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Correspondence to Michelle Byrd .

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Byrd, M., Warfield, C., Brookshire, K., Ostarello, L. (2018). Screening for Behavioral Health Problems in Adult Primary Care. In: Duckworth, M., O'Donohue, W. (eds) Behavioral Medicine and Integrated Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93003-9_5

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