[The Psychiatrist and patients with mild intellectual disability or borderline intellectual functioning].

Background: A substantial proportion of patients within regular Mental Health Services have a mild intellectual disability (MID) or borderline intellectual functioning (BIF). Previous research has shown that psychiatrists are ambivalent about their own knowledge and skills in providing care to these patients.

Aim: To gain insight into factors that play a role in how psychiatrists experience the provision of care to patients with MID/BIF and comorbid psychiatric disorders.

[How do general practitioners deal with patients they do not consider to be depressed but who are classified as such according the PHQ-9?].

OBJECTIVES How GPs describe their patients who they did not identify as suffering from depression but who were classified as such by PHQ-9? What conclusions can be drawn with regard to how depression is dealt with and the illness model in use? METHOD GPs who took part in a screening study were asked in interviews to talk about some of their patients - not being informed that these were those not identified as depressive by them. This study comprises 21 narrative interviews from 18 GPs. Analysis by Framework method by Lewis and Ritchie.

Fluoroquinolones to treat uncomplicated acute cough in primary care: predictors for unjustified prescribing of antibiotics.

Background: Despite efforts to ensure more accurate prescribing of antibiotics for respiratory tract infections, inappropriate selection of antibiotic treatment remains a big issue. We tried to ascertain which factors best predict the nature of fluoroquinolone prescribing for acute cough in primary care.

Methods: Random effects logistic regression models were applied to the baseline prescription data taken from a cluster-randomized controlled trial based on 104 general practitioners (GPs) and 2745 patients.

[Prevalence and diagnosis of depression in primary care. A critical comparison between PHQ-9 and GPs' judgement].

Objective: Up to 50 % of patients suffering from major depression are not recognised by their general practitioners. On the other hand general practitioners do rate some of their patients as depressive despite the fact that psychiatric diagnostic instruments do not. In this study we wanted to not only analyse the number and proportion of concordant diagnoses between GP and an established psychiatric diagnostic instrument (PHQ-9), but also to analyse the modalities of non-concordant diagnostic classifications.

Drug-adherence questionnaires not valid for patients taking blood-pressure-lowering drugs in a primary health care setting.

Purpose: To validate two established questionnaires [Morisky and Medication Adherence Report Scale (MARS-5)] for the measurement of medical adherence of patients treated with antihypertensive drugs in primary care in Germany.

Setting: General practitioners (GPs) and their patients in North Rhine-Westphalia, Germany.

Methods: GPs were asked to recruit 12 consecutive patients using blood-pressure-lowering medication for at least 12 months.

Reducing antibiotic prescriptions for acute cough by motivating GPs to change their attitudes to communication and empowering patients: a cluster-randomized intervention study.

Objectives: Assessing the efficacy of an educational intervention that aimed to reduce unnecessary antibiotic prescriptions in primary care by motivating GPs to change their attitudes to communication and by empowering patients.

Methods: One hundred and four GPs in North-Rhine/Westphalia-Lippe, Germany were cluster-randomized into intervention and control. GPs randomized to receive the intervention were visited by peers.

[A comparison of different methods of performance assessment for the course in general medicine].

A novel Federal Regulation for Basic Medical Education was issued in Germany, which requires an end of course assessment. General Practice (GP) in Duesseldorf has introduced a written examination. An accompanying study was carried out to understand whether different methods of performance evaluation would show equivalent results intraindividually.

Acute cough: a qualitative analysis of how GPs manage the consultation when patients explicitly or implicitly expect antibiotic prescriptions.

Objective: The aim of this study was to analyse how GPs manage the consultation for acute cough when patients explicitly or implicitly expect antibiotic prescriptions.

Methods: A qualitative analysis of audio-taped consultations was carried out. The participants were eight GPs from eight general practices in Northrhine, Germany and their 42 patients with acute cough over a 2 week period.

[Problems with the treatment of schizophrenics in the doctor's office].

Instead of consulting a psychiatrist, many schizophrenic patients prefer to be treated by their family doctor. The present article describes the typical problems encountered by family doctors treating such patients, and offers practical tips and suggestions. Points of special emphasis are, how to relate to acutely ill schizophrenics, depending on the type of schizophrenia presenting (maniform-aggressive, delusional or hallucinatory), emergency psychopharmacological treatment in acute schizophrenic psychosis, detection of emergent schizophrenia as early as possible, local facilities available to help the schizophrenic patient.