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.

References 

  1. Kroenke K, Arrington MD, Mangelsdorff AD. The prevalence of symptoms in medical outpatients and the adequacy of therapy. Arch Intern Med. 1990;150:1685–1689
  2. Kroenke K, Price RK. Symptoms in the community: prevalence, classification, and psychiatric co-morbidity. Arch Intern Med. 1993;153:2474–2480
  3. Kroenke K, Spitzer RL, Williams JB, Linzer M, et al.  Physical symptoms in primary care. Predictors of psychiatric disorders and functional impairment. Arch Fam Med. 1994;3:774–779
  4. Speckens AE, van Hemert AM, Spinhoven P, et al.  Cognitive behavioral therapy for medically unexplained physical symptoms: a randomized controlled trial. BMJ. 1995;311:1328–1332
  5. Barsky AJ, Cleary PD, Klerman G. Determinants of perceived health status of medical outpatients. Soc Sci Med. 1992;10:1147–1154
  6. Kroenke K, Jackson JL, Chamberlin J. Depressive and anxiety disorders in patients presenting with physical complaints: clinical predictors and outcome. Am J Med. 1997;103:339–347
  7. Barrett JE, Barrett JA, Oxman TE, Gerber PD. The prevalence of psychiatric disorders in primary care. Arch Gen Psychiatry. 1988;45:1100–1106
  8. Schulberg HC, Burns BJ. Mental disorders in primary care: epidemiologic, diagnostic and treatment direction. Gen Hosp Psychiatry. 1988;10:79–87
  9. Spitzer RL, Williams JBW, Kroenke K, Linzer M, deGruy FV, Hahn SR, et al.  Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994;272:1749–1756
  10. Kroenke K, Price R. Symptoms in the community. Prevalence, classification and psychiatric comorbidity. Arch Intern Med. 1993;153:2474–2480
  11. Philbrick JT, Connelly JE, Wofford AB. The prevalence of mental disorders in rural office practice. J Gen Intern Med. 1996;11:9–15
  12. Carson AJ, Ringbauer B, Stone J, McKenzie L, Warlow C, Sharpe M. Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry. 2000;68(2):207–210
  13. O'Malley P, Jackson JL, Kroenke K, Yoon IK, Hornstein E, Dennis GJ. The value of screening for psychiatric disorders in rheumatology referrals. Arch Int Med. 1998;158(21):2357–2362 Nov 23
  14. O'Malley PG, Wong PW, Kroenke K, Roy MJ, Wong RK. The value of screening for psychiatric disorders prior to upper endoscopy. J Psychosom Res. 1998;44(2):279–287
  15. Ormel J, Koster MWJ, Van Den Brink W, Van De Villige G. Recognition, management, and course of anxiety and depression in general practice. Arch Gen Psychiatry. 1991;48:700–706
  16. Banks MH, Beresford SA, Morrell DC, Waller JJ, Watkins CJ. Factors influencing demand for primary medical care in women aged 20–44 years: a preliminary report. Int J Epidemiol. 1975;4:189–195
  17. McFarland BH, Freeborn DK, Mullooly JP, Pope CR. Utilization patterns among long-term enrollees in a prepaid group practice health maintenance organization. Med Care. 1985;23:1221–1223
  18. Zoccolillo MS, Cloninger CR. Excess medical care of women with somatization disorder. South Med J. 1986;79:532–535
  19. Spitzer RL, Kroenke K, Linzer M, Hahn SR, Williams JR, deGruy FV, et al. Health-related quality of life in primary care patients with mental disorders. Results from the Prime-MD 1000 study. JAMA 274(19):1511–17.
  20. Wells KB, Stewart A, Hays RD, et al.  The functioning and well-being of depressed patients: results from the Medical Outcomes Study. JAMA. 1989;262:914–919
  21. Smith GR, Monson RA, Ray DC. Patients with multiple unexplained symptoms. Their characteristics, functional health, and health care utilization. Arch Intern Med. 1986;146:69–72
  22. Berkanovic E, Teleskay C, Reeder S. Structural and social psychological factors in the decision to seek medical care for symptoms. Med Care. 1981;7:693–709
  23. Kroenke K, Jackson JL. Outcome in general medicine patients presenting with common symptoms. A prospective study with 2 week and 3-month follow-up. Fam Pract. 1998;15:398–403
  24. Schappert SM. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: 1997 summary. Vital Health Stat. 1999;13(143):1–26
  25. Ewald H, Rogne T, Ewald K, Fink P. Somatization in patients newly admitted to a neurological department. Acta Psychiatr Scand. 1994;89(3):174–179
  26. Lempert T, Dieterich M, Huppert D, Brandt T. Psychogenic disorders in neurology: frequency and clinical spectrum. Acta Neurol Scand. 1990;82(5):335–340
  27. Crimlisk HL, Bhatia K, Cope H, David A, Marsden CD, Ron MA. Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms. BMJ. 1998;316:582–586
  28. Slavney PR, Teitelbaum ML. Patients with medically unexplained symptoms: DSM-III diagnoses and demographic characteristics. Gen Hosp Psychiatry. 1985;7(1):21–25
  29. Zaubler TS, Katon W. Panic disorder in the general medical setting. J Psychosom Res. 1998;44(1):25–42
  30. Breslau N, Davis GC. Migraine, physical health and psychiatric disorder: a prospective epidemiologic study in young adults. J Psychiatr Res. 1993;27(2):211–221
  31. Franz M, Schepank H, Schellberg D. Unspecific neurologic symptoms as possible psychogenic complaints. Eur Arch Psychiatry Clin Neurosci. 1993;243(1):1–6
  32. Coyle PK, Sterman AB. Focal neurologic symptoms in panic attacks. Am J Psychiatry. 1986;143(5):648–649
  33. Merikangas KR, Angst J, Isler H. Migraine and psychopathology: results of the Zurich cohort study of young adults. Arch Gen Psychiatry. 1990;47(9):849–853
  34. Keck PE, Merikangas KR, McElroy SL, Strakowski SM. Diagnostic and treatment implications of psychiatric comorbidity with migraine. Ann Clin Psychiatry. 1994;6(3):165–171
  35. Kapoor WN, Fortunato M, Hanusa BH, Schulberg RC. Psychiatric illness in patients with syncope. Am J Med. 1995;99:505–512
  36. Kroenke K, Lucas CA, Rosenberg ML, Scherokman BJ. Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med. 1993;8(10):530–535
  37. Sullivan M, Clark MR, Katon WJ, Fischl M, Russo J, Dobie RA, et al. Psychiatric and otologic diagnoses in patients complaining of dizziness. Arch Intern Med. 1993;153(5):590–591
  38. Hiller W, Janca A, Burke KC. Association between tinnitus and somatoform disorders. J Psychosom Res. 1997;43(6):613–624
  39. Johnson JE, Jenkins TR, Pinholt EM, Carpenter JL. Content of ambulatory internal practice in an academic army medical center and an army community hospital. Mil Med. 1998;153:21–25
  40. Jackson JL, Strong J, Cheng E, Meyer G. Patients, diagnoses, and procedures in a military internal medicine clinic, comparison with civilian practices. Mil Med. 1999;164(3):194–197
  41. Jackson JL, O'Malley PG, Kroenke K. A psychometric comparison of military and civilian medical practices. Mil Med. 1999;164(2):112–125
  42. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. JAMA. 1999;282(18):1737–1744
  43. Spitzer RL, Willimas JBW, Kroenke K, Linzer M, deGruy FV, Hahn SR, et al.  The PRIME-MD 1000 study: description, validation, and clinical utility of a new procedure for diagnosis in mental disorders in primary care. JAMA. 1994;272:1749–1756
  44. Kroenke K, Spitzer RL, deGruy FV, Hahn SR, Linzer M, Williams JBW, et al.  Multisomatoform disorder: an alternative to undifferentiated somatoform disorder for the somatizing patient in primary care. Arch Gen Psychiatry. 1997;54:352–358
  45. Kroenke K, Spitzer RL, deGruy FV, Sindle R. A symptom checklist to screen for somatoform disorders in primary care. Psychosomatics. 1998;39:263–272
  46. Jackson JL, Kroenke K, Chamberlin J. A clinical trial to assess the effect of physician knowledge of patient serious illness worry, expectations and psychiatric disorders. Arch Fam Med. 1999;8(2):135–142
  47. Goldberg DP, Blackwell P. Psychiatric illness in general practice. A detailed study using a new method of case identification. Br J Med. 1970;2:439–443
  48. Marks JN, Goldberg DP, Hillier VF. Determinants of the ability of general practitioners to detect psychiatric illness. Psychol Med. 1979;9:337–353
  49. Boardman AP. The general health questionnaire and the detection of emotional disorder by general practitioners. A replicated study. Br J Psychiatry. 1987;151:373–381
  50. Jackson JL, Passamonti M. Impact of undetected mental disorders in primary care. J Gen Intern Med. 2001;16(Suppl 1):142
  51. Merikangas KR, Stevens DE. Comorbidity of migraine and psychiatric disorders. Neurol Clin. Feb 1997;15(1):115–123
  52. Breslau N, Merikangas K, Bowden CL. Comorbidity of migraine and major affective disorders. Neurology. Oct 1994;44(10):S17–S22 Suppl 7
  53. Juang KD, Wang SJ, Fuh JL, Lu SR, Su TP. Comorbidity of depressive and anxiety disorders in chronic daily headache and its subtypes. Headache. 2000;40(10):818–823 Nov–Dec

 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