Treatment of a whole population sample of Alzheimer's disease with donepezil over a 4-year period: lessons learned.

Background: In the UK it is recommended that acetylcholinesterase inhibitors be restricted to patients with moderate Alzheimer's disease, and progress monitored within specialist clinics.

Objective: To describe a cohort of patients with Alzheimer's disease from a whole city population treated with donepezil, and to analyse outcomes over 4 years.

Methods: Historical cohort design: 88 patients recruited 1997-1998, assessed at baseline with 4-year follow-up, using an agreed protocol and validated measures: survival, retention in treatment, cognition, non-cognitive symptoms, weight change, carer stress.

Creating a community-based memory clinic for older people.

This article describes the development of a multidisciplinary, nurse-led memory clinic. The clinic has grown out of research activity to become an important component of a community service for older people with dementia and other mental health problems. A detailed analysis of the interaction between the clinic and the community mental health team, as practised in this model of care, is presented for consideration.

Needs for mental health treatment among general practice attenders.

Background: No study has directly assessed the need for mental health care among those consulting in general practice.

Aims: To make a direct assessment of the needs for mental health care in people with non-psychotic disorders consulting their general practitioner.

Method: In a two-phase study design, consecutive general practice attenders aged 17-65 years were interviewed using the Structured Clinical Interview for DSM-IV Axis I Disorders.

Understanding General Health Questionnaire (GHQ-28) score and its threshold.

Background: The finding of variation in the optimal threshold of the General Health Questionnaire (GHQ) across different settings has proved difficult to explain. This analysis aimed to examine the optimal threshold of the GHQ, its variability and relationship with prevalence of psychiatric disorder.

Methods: A cross-sectional two-phase epidemiological survey was used in a study of non-psychotic psychiatric disorder of General Practice consulters.