[The general practitioner in charge of treatment of patients with bipolar disorder: an exploratory study]. / De huisarts als primaire behandelaar van patiënten met een bipolaire stoornis: een exploratief onderzoek.

BACKGROUND: The role of the general practitioner (gp) in the treatment of severe psychiatric disorders, including bipolar disorder (bd), is under discussion. AIM: To investigate how many patients with a recognised bd are being treated for their illness exclusively in the setting of primary care and to find out how many patients are registrated as having bd on their gp's file. METHOD: We made an exploratory study in a gp's database containing data for 14,254 Dutch adult patients in the Amsterdam over a period of 3.5 years (2010-2013). RESULTS: We found that the gp was in charge of the treatment of bd in less than one patient per practice. The percentage of patients officially recognised as having bd in the database we studied was 0.15%, a percentage that is much lower than the percentage of bd in the Dutch population as a whole. There are several possible explanations for this discrepancy. CONCLUSION: Given these low numbers, it is unlikely that the gps can have adequate experience of giving their bd patients the latest type of treatment. In view of the increasing role played by gps in the treatment of bd, it is important that there is strong collaboration with specialised mental health care, and that a low threshold prevails for consultation and referral.

[Exercise-promoting interventions for encouraging people with schizophrenia to take physical exercise]. / Interventies om mensen met schizofrenie aan het bewegen te krijgen en te houden.

BACKGROUND: Physical activity is of therapeutic value for people with schizophrenia. However, only a small percentage of them is physically active. AIM: To provide an overview, based on scientific evidence, of effective aspects of exercise-promoting interventions that can be used to induce patients with schizophrenia to engage in and continue with physical activity. METHOD: We looked for articles in PubMed and the Cochrane Library on the basis of the search terms 'adherence, 'physical activity', 'exercise, 'schizophrenia, 'psychosis, 'chronic illness; and 'severe mental illness. RESULTS: The exercise-promoting interventions that are the most successful are those which set one goal, involve self-monitoring , stimuli and cues and use a behavioural therapeutic approach. To be effective, interventions also have to be of moderate to high intensity, be integrated into daily life and be professionally supervised, particularly at the beginning. CONCLUSION: Exercise has the potential to make an important and positive contribution to the recovery of patients with schizophrenia and should occupy a prominent position in the arsenal of therapies. Apparently, specific interventions can encourage patients to start taking and continue taking physical exercise.