Evaluation of ICD-10 PHC mental health guidelines in detecting and managing depression within primary care

Background The prevalence of mental disorders in the community is high. yet many remain unrecognised, misdiagnosed or poorly managed within primary ca re. Hence, guidelines for diagnosing and managing mental disorders in prima ry care. ICD-IO PHC, have been developed. Aims To introduce the guidelines into primary care and to assess whether th ey improve recognition, accuracy of diagnosis and treatment standards. Method GPs recorded information on all patients presenting with mental diso rders before and after guidelines were introduced. A 10% sample of patients underwent interviews to establish a formal diagnosis. Recognition of menta l disorders was assessed by screening of patients attending their GP. Results The guidelines had no impact on the overall detection of mental dis orders, the accuracy of diagnosis or the prescription of antidepressants. T here was a significant increase in the number of patients diagnosed with de pression or unexplained somatic symptoms. The GPs also made increased use o f psychological interventions. Conclusions The success of the guidelines in bringing about change is by no means certain. Some areas appeared more susceptible to change than others. Declaration of interest Funding was provided by the Department of Health.