Developing a clinical prediction rule for repeated consultations with functional somatic symptoms in primary care: a cohort study.

Objectives: Patients who present in primary care with chronic functional somatic symptoms (FSS) have reduced quality of life and increased health care costs. Recognising these early is a challenge. The aim is to develop and internally validate a clinical prediction rule for repeated consultations with FSS.

Antidepressant prescriptions and mental health nurses: an observational study in Dutch general practice from 2011 to 2015.

Purpose: The purpose of this study was to investigate developments in antidepressant prescriptions by Dutch general practitioners, alongside the national introduction of mental health nurses. Antidepressant prescriptions are very common in general practice, but are often not in line with recommendations. The recent introduction of mental health nurses may have decreased antidepressant prescriptions, as general practitioners (GPs) have greater potential to offer psychological treatment as a first choice option instead of medication.

Exploring the feasibility of new Dutch mental health policy within a large primary health care centre: a case study.

Background: A reform of Dutch mental health care aimed to substitute care from specialized care to general practice. Since 1 January 2014, Dutch general practitioners (GPs) are no longer allowed to refer patients without a psychiatric disorder to mental health care. Patients with non-complex psychological problems should be treated within general practice.

Applying Computerized Adaptive Testing to the Four-Dimensional Symptom Questionnaire (4DSQ): A Simulation Study.

Background: Efficient screening questionnaires are useful in general practice. Computerized adaptive testing (CAT) is a method to improve the efficiency of questionnaires, as only the items that are particularly informative for a certain responder are dynamically selected.

Objective: The objective of this study was to test whether CAT could improve the efficiency of the Four-Dimensional Symptom Questionnaire (4DSQ), a frequently used self-report questionnaire designed to assess common psychosocial problems in general practice.

Potential for substitution of mental health care towards family practices: an observational study.

Background: Substitution is the shift of care from specialized health care to less expensive and more accessible primary health care. It seems promising for restraining rising mental health care costs. The goal of this study was to investigate a potential for substitution of patients with psychological or social problems, but without severe psychiatric disorders, from Dutch specialized mental health care to primary care, especially family practices.

Patients' readiness to receive psychosocial care during nurse-led routine diabetes consultations in primary care: A mixed methods study.

Background: Patients with type 2 diabetes mellitus face several emotional and social consequences of their chronic illness in their everyday life. Symptoms of distress and depression are prevalent. For providing psychosocial self-management support, nurses in primary care were trained to identify patients with psychosocial problems during routine medically-shaped diabetes consultations.

Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care.

Background: Antidepressant use is often prolonged in patients with anxiety and/or depressive disorder(s) compared with recommendations in treatment guidelines to discontinue after sustained remission.

Aim: To unravel the motivations of patients and GPs causing long-term antidepressant use and to gain insight into possibilities to prevent unnecessary long-term use.

Design And Setting: Qualitative study using semi-structured, in-depth interviews with patients and GPs in the Netherlands.

Consultations in general practices with and without mental health nurses: an observational study from 2010 to 2014.

Objectives: To investigate care for patients with psychological or social problems provided by mental health nurses (MHNs), and by general practitioners (GPs) with and without MHNs.

Design: An observational study with consultations recorded by GPs and MHNs.

Setting: Data were routinely recorded in 161-338 Dutch general practices between 2010 and 2014.

Use of general practice services 5 years after an episode of mental illness: case-control study using electronic records.

Background: Depression, anxiety, and emotional distress occur frequently and are usually treated in general practice. Little has been reported about the long-term course of these conditions and the long-term use of medical services.

Aim: To follow up patients with depression, anxiety, and emotional distress in general practice for 5 years and examine the length and number of index episodes, prescribing behaviour, and the use of services in general practice.

Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP).

Objective: Even though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation.

Methods: A draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility.

A new approach to child mental healthcare within general practice.

Background: Child and adolescent mental health problems are frequently not identified and properly treated within general practice. Politicians in the Netherlands are promoting more primary healthcare treatment for mental health problems. The current study aims to evaluate an integrated primary mental healthcare approach for child and adolescent emotional and behavioural problems.

Changes in general practitioners' sensitivity to patients' distress in low back pain consultations.

Objective: We aim to study GPs' sensitivity to patients' distress and communication on psychosocial factors prior to and after the introduction of the clinical guideline for low back pain.

Methods: Consultations from previous studies on doctor-patient communication in the Netherlands were available for secondary analyses. We selected consultations in which patients presented low back pain complaints (N=168; 25 from 1989, 6 from 1995, 116 from 2001, 21 from 2008) and analyzed these consultations using the Roter Interaction Analysis System (RIAS) and the Verona Coding Definitions of Emotional Sequences (VR-CoDES).

Loneliness is associated with poor prognosis in late-life depression: Longitudinal analysis of the Netherlands study of depression in older persons.

Background: Although depression and loneliness are common among older adults, the role of loneliness on the prognosis of late-life depression has not yet been determined. Therefore, we examined the association between loneliness and the course of depression.

Methods: We conducted a 2-year follow-up study of a cohort from the Netherlands Study of Depression in Older Persons (NESDO).

The role of frailty in the association between depression and somatic comorbidity: results from baseline data of an ongoing prospective cohort study.

Background: Depression and physical frailty in older persons are both associated with somatic diseases, but are hardly examined in concert.

Objectives: To examine whether depression and physical frailty act independently and/or synergistically in their association with somatic diseases.

Design: Baseline data of an ongoing observational cohort study including depressed cases and non-depressed comparison subjects.

Concerns voiced by patients and GPs' responses during psychosocial visits in primary care: a historical cross-sectional study.

Background: In a recent study comparing psychosocial consultations prior to and after the implementation of national clinical guidelines in the Netherlands, we found that general practitioners (GPs) showed less empathy in the more recent consultations. As a consequence, patients possibly have less scope to express their worries. The objective is to investigate whether patients have become more reluctant to open up about their concerns during psychosocial consultations and how GPs respond.

Healthcare utilization in general practice before and after psychological treatment: a follow-up data linkage study in primary care.

Objective: Literature suggests that serious mental health problems increase the use of health services and psychological interventions can reduce this effect. This study investigates whether this effect is also found in primary care patients with less serious mental health problems.

Design/setting: Routine electronic health records (EHR) from a representative sample of 128 general practices were linked to patient files from 150 primary care psychologists participating in the NIVEL Primary Care Database, using a trusted third party.

Implementing guidelines for depression on antidepressant prescribing in general practice: a quasi-experimental evaluation.

Background: Internationally, guidelines for depression recommend a stepped care approach, implying that antidepressant medication should not be offered as a first step treatment to patients with sub-threshold or mild depression. In the Netherlands, antidepressant prescribing rates in general practice as a first treatment step are considered to be high. The aim of this study was to evaluate the implementation of guideline recommendations on antidepressant prescribing.

Talking about psychosocial problems: an observational study on changes in doctor-patient communication in general practice between 1977 and 2008.

Objective: To examine whether GPs' communication styles have changed since the introduction and implementation of clinical guidelines for psychosocial problems in Dutch general practice in the 1990s.

Methods: From a database of 5184 consultations videotaped between 1977 and 2008, 512 consultations assessed by GPs as 'completely psychosocial' were coded with RIAS (Roter Interaction Analysis System). The 121 consultations prior to and 391 consultations after implementation of guidelines were analyzed whether communication styles have changed over time.

Correlates of alcohol abstinence and at-risk alcohol consumption in older adults with depression: the NESDO study.

Objectives: To compare alcohol use between depressed and nondepressed older adults, and to investigate correlates of alcohol abstinence and at-risk alcohol consumption in depressed older adults.

Design: Cross-sectional study.

Setting: Netherlands Study of Depression in Older Persons (NESDO).

[Cutting costs in mental health care: how do we divide the sheep from the goats?].

Dutch Mental Health Services are in the process of being reformed. Specialist Mental Health Services have to be restricted. The realization of these restrictions will need a more fundamental shift in criteria than the DSM classification will be able to provide.

Mental health treatment provided by primary care psychologists in The Netherlands.

Objective: The study examined outcomes of clients treated by primary care psychologists in 2010 in the Netherlands.

Methods: Data for 55,067 clients treated by 613 primary care psychologists were analyzed for three outcomes: regular conclusion of treatment, improvement of >10 points on the Global Assessment of Functioning (GAF), and treatment conclusion in eight or fewer sessions. Logistic regression analyses examined relationships between client characteristics and outcome.

Patients' views on changes in doctor-patient communication between 1982 and 2001: a mixed-methods study.

Background: Doctor-patient communication has been influenced over time by factors such as the rise of evidence-based medicine and a growing emphasis on patient-centred care. Despite disputes in the literature on the tension between evidence-based medicine and patient-centered medicine, patients' views on what constitutes high quality of doctor-patient communication are seldom an explicit topic for research. The aim of this study is to examine whether analogue patients (lay people judging videotaped consultations) perceive shifts in the quality of doctor-patient communication over a twenty-year period.

Determinants of receiving mental health care for depression in older adults.

Background: Major Depressive Disorder (MDD) is common among elderly people. However, it appears that only a minority receives treatment. This study aims to identify and analyse the factors that determine whether elderly people with depressive disorders have contact with health care professionals for mental problems.

Mental health care as delivered by Dutch general practitioners between 2004 and 2008.

Objective: In the field of mental health care, a major role for general practice is advocated. However, not much is known about the treatment and referral of mental health problems in general practice. This study aims at the volume and nature of treatment of mental health problems in general practice; the degree to which treatment varies according to patients' gender, age, and social economic status; and trends in treatment and referral between 2004 and 2008.