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

  • Albert M. Van Hemert (a1), Michiel W. Hengeveld (a1), Jan H. Bolk (a1), Harry G. M. Rooijmans (a1) and Jan P. Vandenbroucke (a1)...
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.

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Corresponding author
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.
References
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American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised. American Psychiatric Association: Washington, DC.
Barsky, A. J., Geringer, E. & Wool, C. A. (1988). A cognitive educational treatment for hypochondriasis. General Hospital Psychiatry 10, 322327.
Bebbington, P., Hurry, J., Tennant, C., Sturt, E. & Wing, J. K. (1981). Epidemiology of mental disorders in Camberwell. Psychological Medicine 11, 561579.
Bland, R. C., Newman, S. C. & Orn, H. (1988). Period prevalence of psychiatric disorders in Edmonton. Acta Psychiatrica Scandinavica 77 (suppl 338), 3342.
Brown, F. W., Golding, J. M. & Smith, R. (1990). Psychiatric comorbidity in primary care somatization disorder. Psychosomatic Medicine 52 445451.
Burvill, P. W. & Knuiman, M. W. (1983). The influence of minor psychiatric morbidity on consulting rates to general practitioners. Psychological Medicine 13, 635643.
Colgan, S., Creed, F. H. & Klass, S. H. (1988). Psychiatric disorders and abnormal illness behaviour in patients with upper abdominal pain. Psychological Medicine 18, 887892.
Computing Resource Center (1990). Stata Reference Manual. Release 2, 4th edn., pp. 393403. Computing Resource Center: Santa Monica, CA.
DeGruy, F., Crider, J., Hashimi, D. K., Dickinson, P., Mullins, H. C. & Troncale, J. (1987). Somatization disorder in a University Hospital. Journal of Family Practice 25, 579584.
Feldman, E., Mayou, R., Hawton, K., Ardern, M. & Smith, E. B. O. (1987). Psychiatric disorders in medical in-patients. Quarterly Journal of Medicine 63, 405412.
Feuerlein, W., Kufner, H., Ringer, Ch. & Antons, K. (1979). The diagnosis of alcoholism: the Munich Alcoholism Test (MALT). International Journal of Rehabilitation Research 2, 533534.
Ford, M. J., Miller, P. M., Eastwood, J. & Eastwood, M. A. (1987). Life events, psychiatric illness and the irritable bowel syndrome. Gut 28, 160165.
Goldberg, D. & Huxley, P. (1980). Mental Illness in the Community. Tavistock: London.
Henderson, S., Duncan-Jones, P., Byrne, D. G., Scott, R. & Adcock, S. (1979). Psychiatric disorders in Canberra. A standardized study of prevalence. Acta Psychiatrica Scandinavica 60, 355374.
Hodiamont, P., Peer, N. & Syben, N. (1987). Epidemiological aspects of psychiatric disorders in a Dutch health area. Psychological Medicine 17, 495505.
Hosmer, D. W. & Lemeshow, S. (1989). Applied Logistic Regression. John Wiley & Sons: New York.
Kellner, R., Abbott, P., Winslow, W. W. & Pathak, D. (1989). Anxiety, depression, and somatization in DSM-III Hypochondriasis. Psychosomatics 30, 5764.
Lobo, A., Perez-Echeverria, J., Artal, J., Rubia, L., Escolar, V., González-Torrecillas, J. L., Morera, B., Dia, J. L. & Miranda, M. (1988). Psychiatric morbidity among medical out-patients in Spain: a case for new methods of classification. Journal of Psychosomatic Research 32, 355364.
Macdonald, A. J. & Bouchier, I. A. D. (1980). Non-organic gastrointestinal illness: a medical and psychiatric study. British Journal of Psychiatry 136, 276283.
Mayou, R. & Hawton, K. (1986). Psychiatric disorders in the general hospital. British Journal of Psychiatry 149, 172190.
Murphy, M. (1989). Somatisation: embodying the problem. The commonest way for psychiatric disorder to present. British Medical Journal 298, 13311332.
Regier, D. A., Boyd, J. H., Burke, J. D., Rae, D. S., Myers, J. K., Kramer, M., Robins, L. N., George, L. K., Karno, M. & Locke, B. Z. (1988). One-month prevalence of mental disorders in the United States. Based on five epidcmiologic catchment area sites. Archives of General Psychiatry 45, 977986.
Sacket, D. L., Haynes, R. B. & Tugwell, P. (1985). Clinical Epidemiology. A Basic Science for Clinical Medicine, pp. 2228. Little, Brown and Company: Boston/Toronto.
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. W. (1966). Psychiatric Illness in General Practice. Oxford University Press: London.
Slooff, C. J., Mulder-Hajonides van der Meulen, W. R. E. H. & Van den Hoofdakker, R. H. (1983). De nederlandse vertaling van de Present State Examination 9e editie. 1. Betrouwbaarheidsaspecten. (The Dutch translation of the Present State Examination 9th edition. I. Aspects of reliability.) Tijdschrift voor Psychiatrie 25, 151163.
Smith, G. R., Monson, R. A. & Ray, D. C. (1986). Psychiatric consultation in somatization disorder. A randomized controlled study. New England Journal of Medicine 314, 14071413.
Toner, B. B., Garfinkel, P. E. & Jeejeebhoy, K. N. (1990). Psychological factors in irritable bowel syndrome. Canadian Journal of Psychiatry 35, 158161.
Walburg, J. A. & Van Limbeek, J. (1987). München Alkohol Test. Swets & Zeitlinger BV: Lisse.
Warwick, H. M. C. (1989). A cognitive-behavioral approach to hypochondriasis and health anxiety. Journal of Psychosomatic Research 33, 705711.
Wing, J. K., Cooper, J. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.
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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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