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Psychiatric disorders in relation to medical illness among patients of a general medical out-patient clinic

Published online by Cambridge University Press:  09 July 2009

Albert M. Van Hemert*
Affiliation:
Department of Psychiatry, Department of Internal Medicine, Department of Clinical Epidemiology, Leiden University Hospital, The Netherlands
Michiel W. Hengeveld
Affiliation:
Department of Psychiatry, Department of Internal Medicine, Department of Clinical Epidemiology, Leiden University Hospital, The Netherlands
Jan H. Bolk
Affiliation:
Department of Psychiatry, Department of Internal Medicine, Department of Clinical Epidemiology, Leiden University Hospital, The Netherlands
Harry G. M. Rooijmans
Affiliation:
Department of Psychiatry, Department of Internal Medicine, Department of Clinical Epidemiology, Leiden University Hospital, The Netherlands
Jan P. Vandenbroucke
Affiliation:
Department of Psychiatry, Department of Internal Medicine, Department of Clinical Epidemiology, Leiden University Hospital, The Netherlands
*
1Address for correspondence: Dr Albert M. van Hemert, Department of Psychiatry, Out-patient Clinic, Leiden University Hospital. Building 1, BI-P, PO Box 9600, 2300 RC Leiden, The Netherlands.

Synopsis

In many patients clinical care in general medical settings is complicated by the presence of psychiatric disorders in addition to the presenting physical symptoms. In the present study the prevalence and type of psychiatric disorders was assessed in relation to the medical diagnostic findings in a general internal medicine out-patient clinic. The Present State Examination, a standardized psychiatric interview, was used to detect psychiatric disorders in 191 newly referred patients. Psychiatric disorders were found to be particularly prevalent among patients with medically ill-explained or unexplained symptoms. The prevalence of psychiatric disorders was 15% for patients with a medical explanation for their presenting symptom, 45% for patients with ill-explained and 38% for those with unexplained symptoms. Approximately 40% of the patients with psychiatric disorders met DSM-III-R criteria for somatization disorder or hypochondriasis, suggesting that these disorders contributed in particular to general medical out-patient referrals.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1993

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