title: Psychological morbidity in general practice managers: a descriptive and explanatory study.
abstract: BACKGROUND
  Proposals to establish an occupational health service for primary care should be informed by knowledge of the health needs of general practice employees.
  
  
  OBJECTIVE
  To determine the prevalence and occupational correlates of stress, anxiety, and depression among practice managers in two contrasting health authorities in England.
  
  
  METHODS
  A postal questionnaire, soliciting information about stress induced by work-related activities, which contained the General Health Questionnaire (GHQ) and Hospital Anxiety and Depression Scale (HADS), was sent to all 149 practice managers in two health authorities areas of south-east England.
  
  
  RESULTS
  Completed questionnaires were returned by 111 (75%) managers; 41/111 (37%) achieved GHQ case status with scores on HADS indicating that 49/111 (44%) classified themselves as anxious and 19/111 (17%) as depressed. The likelihood of being a case was found to be higher in managers from practices with larger numbers of GP partners (P = 0.02) and in managers from practices not in receipt of deprivation payments (P = 0.03). Multiple logistic regression showed that managers' perceived difficulties with general practice administration duties (relative ratio [RR] = 3.27, 95% confidence interval [CI] = 1.22-8.75) and dealings with GPs (RR = 1.86, 95% CI = 1.03-3.34) were the most powerful predictors of case status.
  
  
  CONCLUSIONS
  The questionnaire uncovered high prevalences of self-reported stress, anxiety, and depression in general practice managers. Although the vast majority of National Health Service (NHS) employees have access to an occupational health service, no such source of support exists for those working in general practice. The NHS needs to establish an occupational health service that caters to the needs of clinical and non-clinical members of primary health care teams.
authors.affiliation: Department of General Practice and Primary Health Care, Imperial College School of Medicine, London. aziz.sheikh@ic.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Sheikh
authors.forename: B
authors.initials: B
authors.lastname: Hurwitz
mesh_terms: D000288:Administrative Personnel / Q000523:psychology*; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology; D009786:Occupational Health Services / Q000600:supply & distribution*; D011216:Practice Management, Medical; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology