A Cross-Sectional Study of the Prevalence and Determinants of Common Mental Health Problems in Primary Care in Switzerland.

This study investigated the prevalence of the most common mental health symptoms in a large primary care patient population and characterized their determinants. Data came from a 2015-16 cross-sectional study of a primary care population in Switzerland. An investigator presented the study to patients in waiting rooms, and 1,103 completed a tablet-based questionnaire measuring stress in daily life, sleep disorders and anxiety and depressive symptoms.

[Prescription of psychotherapy provided by psychologists : a new role for general practitioners ?].

This article focuses on the new model for prescribing psychotherapy provided by psychologists that has been in effect in Switzerland since July 1, 2022. Psychologists can now practice as independent providers with a prescription from a primary care physician for a given number of sessions. This new law, which should facilitate access to mental health care, introduces new administrative issues for general practitioners and transforms their relationship with their patients and psychologists.

[Practical management of post-COVID-19 condition. Update and illustration by clinical situations].

Persistent manifestations of COVID-19, known as «long COVID» or post-COVID-19 condition (RA02, CIM-11), affect many infected individuals, with a 24-month prevalence depending on the studies context (18 % in a recent Swiss study). The diversity of clinical presentation, the sometimes complex diagnostic methods, and the multidisciplinary management highlight the importance of a holistic approach, with practical advice for assessing work capacity in the outpatient setting. This article offers an update and synthesis of current knowledge concerning post-COVID-19 condition with practical recommendations for primary care medicine, illustrated by real clinical situations.

Clinical impact and misdiagnosis of functional ophthalmological symptoms: a case report.

Background: There is a high prevalence of somatoform disorders and medically unexplained symptoms. When it comes to deciding whether a patient is able to work, it is essential to differentiate a somatoform disorder from a factitious disorder. The case presented demonstrates the impact on disability benefits and the subsequent psychosocial repercussions of misdiagnosing between a factitious disorder and a somatoform disorder.

Intensive and Brief Psychodynamic Psychotherapy in Severely Depressed Inpatients: A Case Study and Thematic Analysis.

Psychotherapy added to usual hospital care is beneficial. This study reports on two contrasting cases, one responder and one nonresponder, from a randomized controlled trial on the effectiveness of intensive and brief psychodynamic psychotherapy (IBPP) for depressed inpatients, in which reduction in depressive severity was maintained for up to 1 year after completion of IBPP. We aimed to explore how the psychotherapist and patient interacted to work through the themes of focalization (described in the IBPP manual) and how their work was part of a potential process of change.

[Persistent Postural-Perceptual Dizziness (PPPD) - A clinical case and essentials for the primary care medicine].

Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional disorder that manifests with symptoms of dizziness, unsteadiness or non-spinning vertigo that lasts for at least three months. These symptoms are exacerbated by upright posture, active or passive motion, and exposure to complex or moving visual stimuli. This -pathology has been known for a long time ago.

Psychiatric consultation in general practitioners' daily practice: a qualitative study on the experience of consultation-liaison psychiatry interventions in primary care settings in French-speaking Switzerland.

Background: Mental disorders are frequent in primary care settings, which is challenging for primary care physicians. In Neuchâtel (Switzerland), a Consultation-Liaison psychiatrist integrated three primary care group practices, proposing both clinical interventions and supervisions/psychiatric training. Primary care physicians' experience regarding this collaboration was investigated.

Risk Perception Related to COVID-19 and Future Affective Responses Among Healthcare Workers in Switzerland: A Mixed-Methods Longitudinal Study.

Whereas early findings suggest that risk perceptions related to COVID-19 affect psychological well-being in healthcare workers (HCWs), the temporal associations between these variables need to be clarified and HCWs lived experience further explored. This study proposes a mixed evaluation of COVID-19-related risk perception and affective responses among HCWs. A longitudinal mixed-method study was conducted.

[Psychiatric liaison III: Research].

Liaison psychiatry consists of an activity of consultation for patients affected by somatic diseases and of an activity of liaison for clinicians. The liaison work can take different forms, such as teaching of patient-physician relationship, supervision or support. To illustrate psychiatric liaison research, we present four studies conducted in our service, which explore (a) the relations between medical students' mental health and their interpersonal competence, (b) the dreams of medical students and what they reveal of their subjectivities, (c) the stakes for primary care practitioners when asking for a specialist's consult, and (d) the situated clinical practice.

[2021 scientific breakthroughs in ambulatory general internal medicine].

Psychotherapy diminishes depression relapses when antidepressants are reduced or stopped. Delayed antibiotic therapy is effective and safe while treating community-acquired respiratory infection. Physical rehabilitation after hospitalization due to acute cardiac decompensation is useful in frail patients.

[Social integration income medical advisor : update in 2021].

The social and professional measures suggested to beneficiaries of the Insertion Income have demonstrated their effectiveness. However, presence of mental disorders complicates their implementation, causing difficulties for both beneficiaries and social services. The integration of psychiatrist as medical advisors, as for the canton of Vaud, helps to support the role of medical advisors.

[Case discussion groups : « training or treatment » ?].

Since the creation of Balint groups in the 1950s, the concept of meeting among doctors to discuss difficult clinical situations has spread widely, whether or not in line with Michael Balint's initial model. While the latter had thought of these groups as training, their therapeutic role was quickly questioned in the medical literature. At a time when we are seeing and concerned about the poor mental health of primary care doctors, we wanted to show that the added value provided by participation in a practice exchange group is both formative and therapeutic.

[« Group medical practices » project : collaboration between primary care medicine and institutional public psychiatry].

Collaboration between primary care medicine and psychiatry is a well-known challenge. In order to improve access to psychological care for patients undergoing primary care, the « group medical practices » project proposes a collaborative care model in which a psychiatrist employed by a public psychiatric institution integrates group medical practices in order to provide assistance to primary care physicians. It is thus able to evaluate patients directly in the practices and to offer supervision and consilium spaces to primary care physicians.

[Psychogenic polydipsia : a (still) unknown psychosomatic entity].

Psychogenic polydipsia, as well referred to as « potomania », is a clinical entity that can be found in psychiatric as well as in physical care settings. Its diagnosis is based on the detection of an excessive fluid intake along with a polyuria, after excluding any potential somatic cause of this clinical presentation. Given the different somatic complications and care complexity, early detection and multidisciplinary interventions are necessary.

General practitioners referring patients to specialists in tertiary healthcare: a qualitative study.

Background: There is a large and unexplained variation in referral rates to specialists by general practitioners, which calls for investigations regarding general practitioners' perceptions and expectations during the referral process. Our objective was to describe the decision-making process underlying referral of patients to specialists by general practitioners working in a university outpatient primary care center.

Methods: Two focus groups were conducted among general practitioners (10 residents and 8 chief residents) working in the Center for Primary Care and Public Health (Unisanté) of the University of Lausanne, in Switzerland.

Difficult patient-doctor encounters in a Swiss university outpatient clinic: cross-sectional study.

Introduction: Previous research has shown that multiple factors contribute to healthcare providers perceiving encounters as difficult, and are related to both medical and non-medical demands.

Aim: To measure the prevalence and to identify predictors of encounters perceived as difficult by medical residents.

Design And Setting: Cross-sectional study at the Department of Ambulatory Care and Community Medicine (DACCM), a university outpatient clinic with a long tradition of caring for vulnerable patients.

[From a different angle : supervision of general internal medicine practitioners by psychiatrists and its benefits].

The supervision of general internal medicine practitioners by psychiatrists is an opportunity to take a step back from the daily medical practice. In this article, we adopt an interdisciplinary perspective on these supervisory practices, combining a number of insights and perspectives from both psychiatry and sociology. We aim at initiating a broader and more rigorous reflection on such supervisions, which remain little theorized although they are clearly appreciated by those who benefit from them.

[What remains of our Balints ?].

In addition to providing psychiatric care to patients with somatic diseases, liaison psychiatry plays a role in the teaching of the relational aspects of medical practice. This series of three articles offers a critical reflection on this topic and examples of educational programs developed at Lausanne University Hospital. In the Department of Ambulatory Care and Community Medicine, an intervention inspired by Balint groups offers to residents in general internal medicine the possibility of working through their clinical experiences and their evolving professional identity.