Pub Date : 2001-09-01DOI: 10.2190/HQXL-FV6T-03UF-XANH
A. Alao, Steven A. Naprawa
This article explores the association between normal pressure hydrocephalus and psychiatric symptoms, such as depressed mood, delusions, and hallucinations. We are reporting a case of a 30-year-old female with a history of congenital hydrocephalus, is used to illustrate this association. Such patients may benefit from treatment with ventriculoperitoneal or ventriculoatrial shunt procedures.
{"title":"Psychiatric Complications of Hydrocephalus","authors":"A. Alao, Steven A. Naprawa","doi":"10.2190/HQXL-FV6T-03UF-XANH","DOIUrl":"https://doi.org/10.2190/HQXL-FV6T-03UF-XANH","url":null,"abstract":"This article explores the association between normal pressure hydrocephalus and psychiatric symptoms, such as depressed mood, delusions, and hallucinations. We are reporting a case of a 30-year-old female with a history of congenital hydrocephalus, is used to illustrate this association. Such patients may benefit from treatment with ventriculoperitoneal or ventriculoatrial shunt procedures.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"44 1","pages":"337 - 340"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90895646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-09-01DOI: 10.2190/X28K-GDAY-75QV-G69N
H. Koenig
In the fourth and final article of this religion and medicine series, I summarize the results of a comprehensive and systematic review of research examining religion's relationship to physical health and mortality. This review focuses on pain and disability, cardiovascular disease, immune and neuroendocrine function, susceptibility to infection, cancer, and overall mortality. I also explore what these research findings mean for medical practice and suggest patient-centered applications that are sensitive to ethical concerns.
{"title":"Religion and Medicine IV: Religion, Physical Health, and Clinical Implications","authors":"H. Koenig","doi":"10.2190/X28K-GDAY-75QV-G69N","DOIUrl":"https://doi.org/10.2190/X28K-GDAY-75QV-G69N","url":null,"abstract":"In the fourth and final article of this religion and medicine series, I summarize the results of a comprehensive and systematic review of research examining religion's relationship to physical health and mortality. This review focuses on pain and disability, cardiovascular disease, immune and neuroendocrine function, susceptibility to infection, cancer, and overall mortality. I also explore what these research findings mean for medical practice and suggest patient-centered applications that are sensitive to ethical concerns.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"29 1","pages":"321 - 336"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87361964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/2YBG-NL9T-EK7Y-F6A3
H. Koenig
In this third of a four-article series on religion and medicine, I describe a theoretical model to illustrate the complex pathways by which religion may influence physical health. Genetic factors, childhood training, psychological and social influences, health behaviors, and healthcare practices are discussed as part of this model. Considerable space is given to recent advances in psychoneuroimmunology and to stress-induced cardiovascular changes that demonstrate physiological pathways by which cognitive, emotional, and behavioral processes may influence susceptibility to disease and disease course. I also discuss research illustrating the important role that social support plays in moderating the physiological effects of stress and improving health outcomes. If religious beliefs and practices improve coping, reduce stress, prevent or facilitate the resolution of depression, improve social support, promote healthy behaviors, and prevent alcohol and drug abuse, then a plausible mechanism exists by which physical health may be affected.
{"title":"Religion and Medicine III: Developing a Theoretical Model","authors":"H. Koenig","doi":"10.2190/2YBG-NL9T-EK7Y-F6A3","DOIUrl":"https://doi.org/10.2190/2YBG-NL9T-EK7Y-F6A3","url":null,"abstract":"In this third of a four-article series on religion and medicine, I describe a theoretical model to illustrate the complex pathways by which religion may influence physical health. Genetic factors, childhood training, psychological and social influences, health behaviors, and healthcare practices are discussed as part of this model. Considerable space is given to recent advances in psychoneuroimmunology and to stress-induced cardiovascular changes that demonstrate physiological pathways by which cognitive, emotional, and behavioral processes may influence susceptibility to disease and disease course. I also discuss research illustrating the important role that social support plays in moderating the physiological effects of stress and improving health outcomes. If religious beliefs and practices improve coping, reduce stress, prevent or facilitate the resolution of depression, improve social support, promote healthy behaviors, and prevent alcohol and drug abuse, then a plausible mechanism exists by which physical health may be affected.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"26 2 1","pages":"199 - 216"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85676728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/3NB2-VVUY-P8N3-7XKQ
David I. Smith, K. Scoullar
Objective: To investigate the extent of knowledge of Australian general practitioners (GPs) in terms of critical information about adolescent suicide. Method: GPs knowledge about adolescent suicide was assessed using the 39-item Adolescent Suicide Behaviour Questionnaire (ASBQ), distributed to all GPs listed on the Medical Practitioners Board register of the Australian state of Victoria. Forty-three percent of GPs (n = 1694) completed and returned the survey. Results: GPs scored, on average, 71 percent of the questionnaire items correct. The mean level of incorrect and uncertain responses was 14 percent and 15 percent, respectively. However, there were wide differences in the number of correct scores between individual GPs, with some respondents scoring as few as four items correct and others as many as 38 items correct. Analysis of knowledge rates within ABSQ content domains showed that GPs were generally well informed about adolescent suicide in relation to precipitating factors, and less well informed about the remaining content domains. Conclusions: Australian GPs are, in general, moderately well informed, and are in a unique position to identify those at risk and to provide appropriate intervention (or referral). However, there is considerable variability in the accuracy of beliefs about adolescent suicide, with some GPs demonstrating excellent knowledge levels but others holding little accurate information. The extent of this variability in knowledge is a cause for concern. Findings highlight the need for ongoing education of GPs as an essential component of prevention strategies for youth suicide.
{"title":"How Well Informed are Australian General Practitioners about Adolescent Suicide? Implications for Primary Prevention","authors":"David I. Smith, K. Scoullar","doi":"10.2190/3NB2-VVUY-P8N3-7XKQ","DOIUrl":"https://doi.org/10.2190/3NB2-VVUY-P8N3-7XKQ","url":null,"abstract":"Objective: To investigate the extent of knowledge of Australian general practitioners (GPs) in terms of critical information about adolescent suicide. Method: GPs knowledge about adolescent suicide was assessed using the 39-item Adolescent Suicide Behaviour Questionnaire (ASBQ), distributed to all GPs listed on the Medical Practitioners Board register of the Australian state of Victoria. Forty-three percent of GPs (n = 1694) completed and returned the survey. Results: GPs scored, on average, 71 percent of the questionnaire items correct. The mean level of incorrect and uncertain responses was 14 percent and 15 percent, respectively. However, there were wide differences in the number of correct scores between individual GPs, with some respondents scoring as few as four items correct and others as many as 38 items correct. Analysis of knowledge rates within ABSQ content domains showed that GPs were generally well informed about adolescent suicide in relation to precipitating factors, and less well informed about the remaining content domains. Conclusions: Australian GPs are, in general, moderately well informed, and are in a unique position to identify those at risk and to provide appropriate intervention (or referral). However, there is considerable variability in the accuracy of beliefs about adolescent suicide, with some GPs demonstrating excellent knowledge levels but others holding little accurate information. The extent of this variability in knowledge is a cause for concern. Findings highlight the need for ongoing education of GPs as an essential component of prevention strategies for youth suicide.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"31 1","pages":"169 - 182"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91382755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/8YRG-3WCB-RYDX-GD5H
W. Bobo, Shannon C Miller
Despite the high prevalence of substance use disorders, the prevention and treatment of such illnesses seem to receive little attention during physician training. This provides cause for concern, as physician involvement in addiction treatment has been relatively sparse. We present the case of a patient whose successful treatment likely relied upon her physicians' intensive training in each of the biological, psychological, and social aspects of her clinical presentation. The case illustrates the need for added emphasis on the assessment and treatment of addictive disorders during medical training, and for more active physician involvement in addictions treatment.
{"title":"Complicated Dual Diagnosis: A Case for Physician Involvement in Addictions Treatment","authors":"W. Bobo, Shannon C Miller","doi":"10.2190/8YRG-3WCB-RYDX-GD5H","DOIUrl":"https://doi.org/10.2190/8YRG-3WCB-RYDX-GD5H","url":null,"abstract":"Despite the high prevalence of substance use disorders, the prevention and treatment of such illnesses seem to receive little attention during physician training. This provides cause for concern, as physician involvement in addiction treatment has been relatively sparse. We present the case of a patient whose successful treatment likely relied upon her physicians' intensive training in each of the biological, psychological, and social aspects of her clinical presentation. The case illustrates the need for added emphasis on the assessment and treatment of addictive disorders during medical training, and for more active physician involvement in addictions treatment.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"63 1","pages":"233 - 235"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90497102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/C7WY-RELT-3U1N-JX9C
David G. Didden, J. Philbrick, J. Schorling
Objective: To determine the prevalence of anxiety and depression in a residents' clinic and if these diagnoses are associated with patients being perceived as difficult, as well as how often these diagnoses are documented in the patients' charts. Methods: This was a cross-sectional study conducted in a general internal medicine residents' clinic. A total of 135 patients were given the Primary Care Evaluation of Mental Disorders questionnaire (DSM-IIIR version) and their physicians filled out the Difficult Doctor-Patient Relationship Questionnaire after the visit. Charts were reviewed for documentation of a diagnosis of anxiety or depression. Results: Major depression was present in 26 percent, dysthymia 16 percent, major depression in partial remission 9 percent, generalized anxiety disorder 13 percent, and panic disorder 7 percent. Overall, 38 percent had at least one and 21 percent had more than one diagnosis. Of patients with one psychiatric diagnosis, 9 percent were classified as difficult versus 100 percent of patients with four diagnoses. Documentation of depression was noted for 43 percent of patients with major depression but only 9 percent with an anxiety disorder. Conclusions: Anxiety and depression were very common among the patients in this clinic, and increasing numbers of diagnoses were associated with patients being classified as difficult. Residents diagnosed depressive disorders as often as practicing physicians in other studies, but anxiety less well. The high prevalence of mental disorders has implications for resident education in that they need to be prepared to care for these patients, but residents also may benefit from exposure to sites with more typical prevalences of these illnesses.
{"title":"Anxiety and Depression in an Internal Medicine Resident Continuity Clinic: Difficult Diagnoses","authors":"David G. Didden, J. Philbrick, J. Schorling","doi":"10.2190/C7WY-RELT-3U1N-JX9C","DOIUrl":"https://doi.org/10.2190/C7WY-RELT-3U1N-JX9C","url":null,"abstract":"Objective: To determine the prevalence of anxiety and depression in a residents' clinic and if these diagnoses are associated with patients being perceived as difficult, as well as how often these diagnoses are documented in the patients' charts. Methods: This was a cross-sectional study conducted in a general internal medicine residents' clinic. A total of 135 patients were given the Primary Care Evaluation of Mental Disorders questionnaire (DSM-IIIR version) and their physicians filled out the Difficult Doctor-Patient Relationship Questionnaire after the visit. Charts were reviewed for documentation of a diagnosis of anxiety or depression. Results: Major depression was present in 26 percent, dysthymia 16 percent, major depression in partial remission 9 percent, generalized anxiety disorder 13 percent, and panic disorder 7 percent. Overall, 38 percent had at least one and 21 percent had more than one diagnosis. Of patients with one psychiatric diagnosis, 9 percent were classified as difficult versus 100 percent of patients with four diagnoses. Documentation of depression was noted for 43 percent of patients with major depression but only 9 percent with an anxiety disorder. Conclusions: Anxiety and depression were very common among the patients in this clinic, and increasing numbers of diagnoses were associated with patients being classified as difficult. Residents diagnosed depressive disorders as often as practicing physicians in other studies, but anxiety less well. The high prevalence of mental disorders has implications for resident education in that they need to be prepared to care for these patients, but residents also may benefit from exposure to sites with more typical prevalences of these illnesses.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"10 1","pages":"155 - 167"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89614623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/K7AU-9UX9-W8BW-TETL
J. Brosschot, H. R. Aarsse
Objective: Medically unexplained symptoms or syndromes, such as fibromyalgia (FM), might be partly caused or sustained by a mechanism involving restricted emotional processing (REP) and the subsequent attribution of emotional arousal to somatic or syndrome-consistent causes. In this study, it was hypothesized that FM patients, compared to healthy individuals, would be higher on trait measures of REP (defensiveness and alexithymia), and would show affective-autonomic response dissociation, that is, higher standardized scores of heart rate responses than affective responses, during negative emotional stimulation. Additionally, FM patients were expected to attribute their bodily symptoms more to somatic than to psychological causes. Method: Emotional movie excerpts were shown to 16 female FM patients and 17 healthy women. Affective response and heart rate were monitored continuously, while symptoms and their causal attributions were measured before and after the excerpts. Repressor coping style and alexithymia were measured, along with negative affectivity and habitual attributions of somatic complaints. Results: FM patients nearly all showed the relatively uncommon combination of high defensiveness and high anxiousness. Compared with healthy women FM patients were more alexithymic, showed a higher level of affective-autonomic response dissociation, and lower within-subject emotional variability. The groups showed opposite attributional patterns, with FM patients attributing symptoms less to psychological causes and more to somatic causes. There was no evidence of a shift in these attributions caused by the emotional stimuli. Conclusions: The results provide preliminary support for the hypotheses. Both at trait and at state level, FM showed restricted emotional processing on most of the parameters measured, and a high ratio of somatic to psychological symptom attribution, coupled with high negative affectivity.
{"title":"Restricted Emotional Processing and Somatic Attribution in Fibromyalgia","authors":"J. Brosschot, H. R. Aarsse","doi":"10.2190/K7AU-9UX9-W8BW-TETL","DOIUrl":"https://doi.org/10.2190/K7AU-9UX9-W8BW-TETL","url":null,"abstract":"Objective: Medically unexplained symptoms or syndromes, such as fibromyalgia (FM), might be partly caused or sustained by a mechanism involving restricted emotional processing (REP) and the subsequent attribution of emotional arousal to somatic or syndrome-consistent causes. In this study, it was hypothesized that FM patients, compared to healthy individuals, would be higher on trait measures of REP (defensiveness and alexithymia), and would show affective-autonomic response dissociation, that is, higher standardized scores of heart rate responses than affective responses, during negative emotional stimulation. Additionally, FM patients were expected to attribute their bodily symptoms more to somatic than to psychological causes. Method: Emotional movie excerpts were shown to 16 female FM patients and 17 healthy women. Affective response and heart rate were monitored continuously, while symptoms and their causal attributions were measured before and after the excerpts. Repressor coping style and alexithymia were measured, along with negative affectivity and habitual attributions of somatic complaints. Results: FM patients nearly all showed the relatively uncommon combination of high defensiveness and high anxiousness. Compared with healthy women FM patients were more alexithymic, showed a higher level of affective-autonomic response dissociation, and lower within-subject emotional variability. The groups showed opposite attributional patterns, with FM patients attributing symptoms less to psychological causes and more to somatic causes. There was no evidence of a shift in these attributions caused by the emotional stimuli. Conclusions: The results provide preliminary support for the hypotheses. Both at trait and at state level, FM showed restricted emotional processing on most of the parameters measured, and a high ratio of somatic to psychological symptom attribution, coupled with high negative affectivity.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"14 1","pages":"127 - 146"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75553761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/YCND-9Y51-KG8T-61E5
M. Al-Sharbati, Noona Viernes, Ala'adin Al-Hussaini, Z. Zaidan, P. Chand, S. Al-Adawi
We report a case of a 14-year-old girl who presented, following a sudden onset, with bilateral ptosis, gait disturbance, difficulty swallowing and loss of appetite, right hypochondriacal pain, and frontal headache. Protracted neurological and medical examinations were unremarkable; neither was precipitating psychological stresses evident. The condition, which manifest as typical conversion disorder, lasted for one year. “Treatment” involving electrical stimulation of both eyes muscles and legs with positive reassurance resolved the symptom. This case supports the view that conversion disorder, not only involves a strong element of suggestion, but also incorporates socio-cultural sanctioned prescription.
{"title":"A Case of Bilateral Ptosis with Unsteady Gait: Suggestibility and Culture in Conversion Disorder","authors":"M. Al-Sharbati, Noona Viernes, Ala'adin Al-Hussaini, Z. Zaidan, P. Chand, S. Al-Adawi","doi":"10.2190/YCND-9Y51-KG8T-61E5","DOIUrl":"https://doi.org/10.2190/YCND-9Y51-KG8T-61E5","url":null,"abstract":"We report a case of a 14-year-old girl who presented, following a sudden onset, with bilateral ptosis, gait disturbance, difficulty swallowing and loss of appetite, right hypochondriacal pain, and frontal headache. Protracted neurological and medical examinations were unremarkable; neither was precipitating psychological stresses evident. The condition, which manifest as typical conversion disorder, lasted for one year. “Treatment” involving electrical stimulation of both eyes muscles and legs with positive reassurance resolved the symptom. This case supports the view that conversion disorder, not only involves a strong element of suggestion, but also incorporates socio-cultural sanctioned prescription.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"3 1","pages":"225 - 232"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87648615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/22q3-eu8l-rpgq-mqhy
{"title":"National Institute of Mental Health—Abstracts","authors":"","doi":"10.2190/22q3-eu8l-rpgq-mqhy","DOIUrl":"https://doi.org/10.2190/22q3-eu8l-rpgq-mqhy","url":null,"abstract":"","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"16 1","pages":"237 - 238"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80920801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-06-01DOI: 10.2190/2X44-CR14-YHJC-9EQ3
G. Jones, S. Ames, S. Jeffries, I. Scarinci, P. Brantley
Objective: Anxiety disorders appear to influence morbidity and medical utilization. However, little is known about the relationship between Generalized Anxiety Disorder, quality of life, and medical utilization, especially among low-income patients. The goals of this investigation were to 1) determine if low-income patients with GAD utilize medical services more than patients with other Axis I diagnoses, or no psychopathology, and 2) compare the health-related quality of life of these three groups. Method: Participants were randomly recruited from public primary care clinics and administered intake assessments of demographics, stress, and health-related self-report questionnaires. At the end of the first year a structured psychiatric interview was administered (N = 431). Over the second year, patients (n = 360) were administered a health-related quality of life measure every three months for four assessments. Medical charts were abstracted to collect information about chronic illnesses and visits to outpatient clinics and the emergency department during the two years. Results: Patients were predominantly middle-aged, low-income, uninsured African-American females. In this low-income sample, patients with GAD utilized the emergency department more and reported poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Conclusion: Low-income patients with GAD utilize the emergency department more and report poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Programs to identify and treat patients with GAD may yield improvements in quality of life, as well as reduce emergency department utilization.
{"title":"Utilization of Medical Services and Quality of Life among Low-Income Patients with Generalized Anxiety Disorder Attending Primary Care Clinics","authors":"G. Jones, S. Ames, S. Jeffries, I. Scarinci, P. Brantley","doi":"10.2190/2X44-CR14-YHJC-9EQ3","DOIUrl":"https://doi.org/10.2190/2X44-CR14-YHJC-9EQ3","url":null,"abstract":"Objective: Anxiety disorders appear to influence morbidity and medical utilization. However, little is known about the relationship between Generalized Anxiety Disorder, quality of life, and medical utilization, especially among low-income patients. The goals of this investigation were to 1) determine if low-income patients with GAD utilize medical services more than patients with other Axis I diagnoses, or no psychopathology, and 2) compare the health-related quality of life of these three groups. Method: Participants were randomly recruited from public primary care clinics and administered intake assessments of demographics, stress, and health-related self-report questionnaires. At the end of the first year a structured psychiatric interview was administered (N = 431). Over the second year, patients (n = 360) were administered a health-related quality of life measure every three months for four assessments. Medical charts were abstracted to collect information about chronic illnesses and visits to outpatient clinics and the emergency department during the two years. Results: Patients were predominantly middle-aged, low-income, uninsured African-American females. In this low-income sample, patients with GAD utilized the emergency department more and reported poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Conclusion: Low-income patients with GAD utilize the emergency department more and report poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Programs to identify and treat patients with GAD may yield improvements in quality of life, as well as reduce emergency department utilization.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"42 1","pages":"183 - 198"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79961925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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