Behavioral Screening in Adult Primary Care
The Importance of Screening in Integrated Care
From the moment patient are seen by a nurse in the primary care setting, they are placed on a multifaceted decision tree designed to screen for myriad medical diagnoses ranging from minor annoyances to life-threatening illnesses. Unfortunately, it is typically only when medical etiologies have been ruled out that the decision tree branches sufficiently to include psychological concerns and disorders. The integrated care setting invites the opportunity to screen for psychological problems while screening for medical etiologies. However, in doing so, the complexity of the already daunting task of identifying the likely causes of a patient’s distress increases exponentially.
Despite the inherent challenge, the value of screening for behavioral issues at (apparently) the same time as the physically based complaints cannot be overstated. As the growing body of literature on integrated care has shown, neglecting behavioral issues ultimately also...
KeywordsBehavioral Health Primary Care Setting Patient Health Questionnaire Primary Care Visit Behavioral Concern
- Alschuler, K. N., Hoodin, F., & Byrd, M. (2008). Integrated care in a college health center: A preliminary investigation. Health Psychology, 27(3), 288–393.Google Scholar
- American Heritage Medical Dictionary (2007). Boston: Houghton Mifflin.Google Scholar
- American Medical Association (2003). Physician Socioeconomic Statistics, 2003. Chicago: AMA. Google Scholar
- Byrd, M. R., & O’Donohue, W. T. (In progress). Assessing behavioral problems in the primary care setting: The development and preliminary evaluation of the pediatric screening inventory.Google Scholar
- Derogaitis, L. R., & Lynn, L. L. (2000). Screening and monitoring psychiatric disorder in primary care populations. In Maruish, M. (Ed.) Introduction, Handbook of psychological assessment in primary care settings (pp. 3–42). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
- Hahn, S. R., Kroenke, K., Williams, J. B. W., & Spitzer, R. L. (2000). Evaluation of mental disorders with the PRIME-MD. In M. Maruish (Ed.), Handbook of psychological assessment in primary care settings (pp. 191–254). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
- Katon, W., Von Korff, M., Lin, E., Lipscomb, P., Russo, J., Wagner, E., et al. (1990). Distressed high utilizers of medical care. DSM-III-R diagnoses and treatment needs. General Hospital Psychiatry, Nov 12(6), 355–62.Google Scholar
- Maruish, M. (2000). Introduction. In M. Maruish (Ed.), Handbook of psychological assessment in primary care settings (pp. 3–42). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
- Robinson, P., & Strosahl, K. (2000). Improving care for a primary care population: Depression as an example. In M. Maruish (Ed.), Handbook of Psychological Assessment in Primary Care Settings (pp. 687–711). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
- Spielberger, C. D., Gorsuch, R. C., & Lushene, R. E. (1970). Manual for the State Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists PressGoogle Scholar
- von Korff, M. & Simon, G. (1996). The relationship between pain and depression. British Journal of Psychiatry, 30, Suppl, 101–108.Google Scholar