Journal of Psychosomatic Research
Volume 57, Issue 1 , Pages 11-16, July 2004

The presence of psychiatric disorders reduces the likelihood of neurologic disease among referrals to a neurology clinic☆

  • John R Ekstrand

      Affiliations

    • Corresponding Author InformationCorresponding author. USA MEDDAC-DCCS, 126 Missouri Avenue, Fort Leonard Wood, MO 65473-8952, USA. Tel.: +1-573-596-0415; fax: +1-573-596-0524
    • General Internal Medicine Service, Walter Reed Army Medical Center, Washington, DC, USA
    • ,
  • Patrick G O'Malley

      Affiliations

    • General Internal Medicine Service, Walter Reed Army Medical Center, Washington, DC, USA
    • ,
  • Robert J Labutta

      Affiliations

    • Department of Neurology, Walter Reed Army Medical Center, Washington, DC, USA
    • ,
  • Jeffery L Jackson

      Affiliations

    • Uniformed Services University of the Health Sciences, Bethesda, MD, USA

Received 4 February 2003; accepted 22 September 2003.

Abstract 

Objectives

This study aims to explore the prevalence and impact of psychiatric disorders on the likelihood of an organic, neurological explanation for symptoms among neurology referrals.

Methods

Consecutive new adult neurology referrals were screened for psychiatric disorders (PRIME-MD) prior to evaluation by neurologists, blinded to these results. Diagnoses were stratified into three categories: no neurological diagnosis, neurological-headache, and neurological-nonheadache.

Results

Of 235 patients enrolled, 79 (34%) received no neurological diagnosis, 54 (23%) headache and 102 (43%) a neurological diagnosis. Overall, 39% had an underlying psychiatric disorder. Patients with psychiatric disorders were less likely to have a neurological diagnosis (RR: 0.66, 95% CI: 0.48–0.90): 25% of patients with a neurological diagnosis had an underlying psychiatric disorder, compared to 43% among those with no diagnosis and 57% among those with headaches.

Conclusion

Psychiatric disorders are common among neurology referrals, particularly those with headaches and are associated with a decreased likelihood of an underlying neurological process.

Keywords:  Anxiety, Depression, Neurology, Psychiatric disorders, Referrals, Somatization

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☆ The opinions or assertions herein are the private views of the authors and are not to be construed as reflecting the views of the Department of the Army or the Department of Defense. The authors have no potential conflicts of interest with any of the material in this manuscript. There was no outside support for this research project and hence no role for a study sponsor. All authors had full access to all the data in the study and accept full responsibility for integrity of the data and the accuracy of the data analysis.

PII: S0022-3999(03)00564-6

doi:10.1016/S0022-3999(03)00564-6

Journal of Psychosomatic Research
Volume 57, Issue 1 , Pages 11-16, July 2004

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