Using electronic medical records to determine prevalence and treatment of mental disorders in primary care: a database study.

OBJECTIVES: With prevention and treatment of mental disorders a challenge for primary care and increasing capability of electronic medical records (EMRs) to facilitate research in practice, we aim to determine the prevalence and treatment of mental disorders by using routinely collected clinical data contained in EMRs. METHODS: We reviewed EMRs of patients randomly sampled from seven general practices, by piloting a study instrument and extracting data on mental disorders and their treatment. RESULTS: Data were collected on 690 patients (age range 18-95, 52% male, 52% GMS-eligible). A mental disorder (most commonly anxiety/stress, depression and problem alcohol use) was recorded in the clinical records of 139 (20%) during the 2-year study period. While most patients with the common disorders had been prescribed medication (i.e. antidepressants or benzodiazepines), a minority had been referred to other agencies or received psychological interventions. 'Free text' consultation notes and 'prescriptions' were how most patients with disorders were identified. Diagnostic coding alone would have failed to identify 92% of patients with a disorder. CONCLUSIONS: Although mental disorders are common in general practice, this study suggests their formal diagnosis, disease coding and access to psychological treatments are priorities for future research efforts.

Antigenic analysis of Trichomonas vaginalis strains by quantitative fluorescent antibody methods.

Clones of 5 Trichomonas vaginalis strains, JH30A, JH31A, JH34A, JH162A, and JH384A, kept in liquid nitrogen (with DMSO serving as the cryoprotectant) after a few weeks of cultivation in axenic cultures, were analyzed for their antigenic properties by quantitative direct fluorescent antibody methods. Measurements of fluorescence of individual cells obtained with the aid of an ultramicrofluorometer indicated that each strain possessed unique antigens as well as antigens it shared with the other strains studied. The relative amounts of common antigens present in each strain were estimated primarily by calculating the percent of fluorescence reduction recorded for organisms stained with their homologous conjugates, nonadsorbed and adsorbed with the homologous and heterologous antigens (strains). Antigenic relationships among the strains were estimated on the basis of statistical analyses of the data obtained in direct, one-step inhibition, and adsorption staining.