Outcome of a training course in psychiatry for primary health care physicians in Abu Dhabi, UAE

Psychological problems constitute 24% of all cases seen in primary health c are (PHC) settings, but only 5.3% of patients present them as the main reas on for their visits. These findings imply that there is underdiagnosis of p sychiatric disorders in PHC. This study was aimed at assessing the outcome of a 2 week course in psychiatry for a group of PHC physicians 1 month and 2 years later. It was a prospective pre-post intervention study. Fourteen P HC physicians were exposed to a 2 week course in psychiatry. A pre-interven tion World Health Organisation questionnaire was administered just before t he course and a post-intervention one was completed 1 month and 2 years aft er the course. A scoring system for three vignette cases (depression, alcoh ol dependency and anxiety with panic attacks) was created and validated by two consultants in order to measure the diagnosis and management skills of the PHC physicians before and after the course. Fifty-seven percent of the sample were not exposed to any postgraduate course in psychiatry and the sa me percentage had no interest. After the course, the self-report of the PHC physicians differed significantly. The referral rate (P = 0.02), the presc ription rate of psychotropic drugs (0.028 for sedatives and 0.05 for tricyc lics) and the number of counselling sessions (P 0.05) increased significant ly for patients with mental disorders. These results were supported by figu res from a Ministry of Health Statistical Report for two PHC centres (where the participating physicians were working). These figures showed an increa se in the number of psychiatric diagnoses (from 205 patients in 1996 to 436 in 1997), an increase in the number of psychiatric referrals (from 37 pati ents in 1996 to 76 in 1997) and an increase in the number of psychotropic m edications prescribed (from 390 tablets in 1996 to 1308 in 1997) (chi (2) = 22.77 and P = 0.00001). The scores for diagnostic skills improved dramatic ally (P = 0.002 for depression, 0.03 for anxiety and 0.05 for alcohol depen dence). For management, only depressive disorders showed a significant chan ge in score (P = 0.009) while skill in managing anxiety (P = 0.01) and alco hol dependence (P = 0.09) did not improve significantly after the course. A 2 week training course in psychiatry for PHC physicians is effective in im proving their diagnostic skills. Management skills, particularly in the are as of anxiety and alcohol dependency, may need a more prolonged and/or diff erent clinical training setting. Primary Care Psychiatry. 2000: 6:77-81. Co pyright (C) 2000 by LibraPharm Limited.