The British journal of general practice : the journal of the Royal College of General Practitioners
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The incidence of schizophrenia in black Caribbeans living in the UK is substantially higher than in the white British population. When first reported, these findings were assumed to be a first-generation migrant effect or merely the result of methodological artefacts associated with inconsistencies in the diagnosis of schizophrenia in black Caribbeans and doubts about population denominators. More recently, it has become clear that the incidence of schizophrenia, based on standardised diagnosis and sophisticated census methods, is higher still in second-generation black Caribbeans. ⋯ A literature search was carried in order to explore possible reasons for the reported excess incidence of schizophrenia in UK-resident black Caribbeans. Competing hypotheses are reviewed and the paper concludes with a summary of specific social and psychological risk factors of significance within the black Caribbean community. Awareness of the factors associated with the onset and presentation of schizophrenia in black Caribbeans may help early diagnosis and rapid access to appropriate treatment which, in turn, appear to be related to improved long-term outcomes.
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Multicenter Study
Complexity of GPs' explanations about mental health problems: development, reliability, and validity of a measure.
How GPs understand mental health problems determines their treatment choices; however, measures describing GPs' thinking about such problems are not currently available. ⋯ Results suggest that the complexity of GPs' psychosocial explanations about common mental health problems can be reliably and validly assessed by this new standardised measure.
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Historical Article
50 years of organised healing in the UK: should we celebrate?
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Multicenter Study
Estimated prevalence of people with learning disabilities: template for general practice.
In 2001, a white paper set out a commitment to ensure that people with a learning disability receive equal access to health services, with an expectation that general practices would have identified all people with a learning disability registered with the practice by June 2004. ⋯ The template provides a valuable tool for general practices to begin developing a practice-based register of patients with a learning disability. This is particularly timely in view of the revised General Medical Services contract Quality and Outcomes Framework indicator, stimulating practices to produce a register of patients with learning disability. Use of a common definition for learning disability is needed to improve consistency in identification across practices.
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Multicenter Study
Identification and guided treatment of ventricular dysfunction in general practice using blood B-type natriuretic peptide.
B-type natriuretic peptide (BNP) is a blood test which detects ventricular wall stretch and is being increasingly used in primary care on limited evidence. ⋯ About 10% of patients with diabetes or cardiovascular disease on GP morbidity registers have a persistently raised plasma BNP concentration. Simple adjustment of their drug treatment may reduce their BNP and associated mortality risk, but further up-titration against BNP is only possible if the within-person biological variability of measurement can be reduced.