Strategies for the prevention of psychiatric disorder in primary care in south London.
Study objective-To compare the potential impact of high risk and population based approaches to the prevention of psychiatric disorder, using a representative sample of general practice attenders as the target population.
Design-This was a prospective cohort study
Setting-A health centre in south London.
Participants-Three hundred and seven consecutive attenders aged 16-65, recruited at randomly selected general practice surgeries.
Main results-A linear association was found between the number of different types of socioeconomic adversity reported at recruitment (T1) and the prevalence of psychiatric disorder one year later (T2).
The population attributable fraction (PAF) for socioeconomic adversity at T1 was 37.4%. In theory, social interventions for high risk individuals at T1 would reduce the prevalence ofpsychiatric disorder at T2 by 9% at most, compared with a reduction of 18% if just one item of socioeconomic adversity were eliminated among those with any socioeconomic risk factors.
Conclusions-Social interventions targeted at individuals at highest risk of the most common mental disorders are likely to be extremely limited in their capacity to reduce the prevalence of these conditions.
A population based risk reduction strategy, modified according to individual risk, represents a potentially feasible and effective alternative.
Mots-clés Pascal : Trouble psychiatrique, Prévention, Risque élevé, Homme, Soin santé primaire, Angleterre, Grande Bretagne, Royaume Uni, Europe, Statut socioéconomique, Londres
Mots-clés Pascal anglais : Mental disorder, Prevention, High risk, Human, Primary health care, England, Great Britain, United Kingdom, Europe, Socioeconomic status
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0402433
Code Inist : 002B30A03B. Création : 19/12/1997.