[Outcome of interactive training in detection and management skills for schizophrenic outpatient treatment by general practitioners].
BACKGROUND
Of all outpatients with a diagnosis of schizophrenia, 30-40% refuse a psychiatrist's care. For this group of patients the general practitioner holds a key position for such different tasks as detection of prodromal schizophrenia or early warning signs of relapse and identification of risk variables for deteriorating outcome, gatekeeping (referral to specialists or other services), integration, and counseling of key relatives. Fifty percent of GPs are interested in disease-specific medical education programs.


METHODS
A control trial examined the changes that participating GPs intended to make in three main topics of the curriculum: (1) changing attitudes (pessimistic outcome expectation, low self-esteem), (2) enhancement of detection skills (prodromal schizophrenia, early warning signs of relapse, and risk factors for poor social and vocational integration), and (3) enhancement of management skills (dosing schemes, motivational interviewing).


RESULTS
In the assessment 2 weeks after the training session, we found significant changes in favor of the trained group in detection and management skills and also improved self-confidence of GPs.


CONCLUSIONS
Problem-oriented and case-based learning strategies should be preferred to lectures in training programs for psychiatric skills in primary care.
Psychiatrische Universitätspoliklinik, Basel, Schweiz. rvauth@uhbs.ch
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Vauth
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Loh
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Sitta
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Schweiger
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Niebling
D000328:Adult; D000553:Ambulatory Care; D003479:Curriculum; D042241:Early Diagnosis; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000193:education*; D005260:Female; D020793:Gatekeeping; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000628:therapy