[Physicians' competence regarding the early diagnosis of dementia: differences between family physicians and primary care neuropsychiatrists in Germany].
OBJECTIVE
Are there any differences between family physicians (FP) and primary care neuropsychiatrists (NP) with regard to their diagnostic competence of early dementia?


METHODS
Trained interviewers presented written case vignettes to 68 NP and 122 FP during a structured interview. The case history described an otherwise healthy 70 years old patient complaining about cognitive disturbances suggesting incipient dementia.


RESULTS
The survey is representative with a high response rate (71.8% FP and 67.3% NP). In both physician groups a vascular disease concept prevailed although the patient had no vascular risk factors. For primary and differential diagnosis NP considered depression more often. Overall only about 50% of physicians considered Alzheimer dementia. Regarding diagnostic methods the NP adhered significantly better to the current guidelines. While 31% of FP would apply dementia screening and 12% order neuroimaging, 76% and 74% of the NP mentioned these methods, respectively.


CONCLUSIONS
There are negligible differences between NP and HA with regard to early diagnostic awareness of dementia. Vascular concepts prevail. However, both groups differ with regard to the diagnostic work-up. An increase of competence seems to be necessary in both groups.
Stoppe
Gabriela
G
Universitäre Psychiatrische Kliniken Basel, Switzerland. Gabriela.stoppe@upkbs.ch
Knoblauch
Anita
A
Haak
Sebastian
S
Maeck
Lienhard
L
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D002983:Clinical Competence; D015140:Dementia, Vascular / Q000175:diagnosis; D003866:Depressive Disorder / Q000175:diagnosis; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005194:Family Practice; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D009462:Neurology; D009483:Neuropsychological Tests; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D011570:Psychiatry