An international study of the effect of physical ill health on psychiatric recovery in primary care

被引:19
作者
Kisely, S
Simon, G
机构
[1] Dalhousie Univ, Dept Psychiat, Clin Res Ctr, Halifax, NS B3H 1V7, Canada
[2] Dalhousie Univ, Dept Epidemiol & Community Hlth, Clin Res Ctr, Halifax, NS B3H 1V7, Canada
来源
PSYCHOSOMATIC MEDICINE | 2005年 / 67卷 / 01期
关键词
medically explained symptoms; psychiatric recovery; primary care;
D O I
10.1097/01.psy.0000149280.88430.7c
中图分类号
R749 [精神病学];
学科分类号
100205 [精神病与精神卫生学];
摘要
Objective: The aim of this study was to determine the association between physical morbidity and recovery from psychiatric illness in primary care. Methods: A total of 1252 psychiatric cases were recruited using a 2-stage design from 5447 subjects presenting for primary care in 14 countries. Cases were assessed at the time of screening and 1 year subsequently. Information on physical, psychiatric, and social status was obtained using the Composite International Diagnostic Instrument adapted for use in primary care (CIDI-PHC) and the Groningen Social Disability Schedule (GSDS). Assessments of psychiatric morbidity were also obtained from the patients' family practitioners. Results: Medically explained somatic symptoms were strongly related to psychiatric outcome 1 year later. Whereas just over one half of patients (614 of 1078) with 4 or less medically explained symptoms had recovered from a psychiatric disorder, the percentage recovery fell to 38% (67 of 174) in those with 5 or more medically explained symptoms. Patients with 5 or more medically explained symptoms had a 70% increase in risk of remaining a psychiatric case 1 year later after controlling for demographics, country, initial severity of psychiatric disorder, medically unexplained somatic symptoms, and social disability. Conclusion: Physical ill health is independently associated with psychologic outcome 1 year after a patient has been seen. The needs of these patients should receive greater attention.
引用
收藏
页码:116 / 122
页数:7
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