The Classification of Psychiatric Morbidity in Attenders at a Dermatology Clinic

1989 ◽  
Vol 155 (5) ◽  
pp. 686-691 ◽  
Author(s):  
S. C. Wessely ◽  
G. H. Lewis
Keyword(s):  
Psychiatric Disorder ◽  
Random Sample ◽  
Skin Disease ◽  
Psychiatric Illness ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Aetiological Factor ◽  
Psychological Care ◽  
Dermatology Clinic

Of a random sample of new attenders at a dermatology out-patient clinic, 40% were classified as suffering from a psychiatric disorder. There was no correlation between psychiatric morbidity and the severity or site of skin disease. Self-report measures of the behavioural impact of skin disease and attitudes to appearance were related to psychological morbidity. Except in subjects without visible skin pathology (5%) there was no evidence that psychiatric illness was an aetiological factor in the development of skin disease. Self-report measures were used to distinguish between those patients in whom psychiatric morbidity was closely related to skin disease (75%), and those in whom it may be coincidental (20%). Psychological care for the former group is most appropriately provided by physicians, who should be encouraged to improve their detection and management of psychiatric morbidity.

The Classification of Psychiatric Morbidity in Attenders at a Dermatology Clinic

1989 ◽  
Vol 155 (05) ◽  
pp. 686-691 ◽  
Author(s):  
S. C. Wessely ◽  
G. H. Lewis
Keyword(s):  
Psychiatric Disorder ◽  
Random Sample ◽  
Skin Disease ◽  
Psychiatric Illness ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Aetiological Factor ◽  
Psychological Care ◽  
Dermatology Clinic

Of a random sample of new attenders at a dermatology out-patient clinic, 40% were classified as suffering from a psychiatric disorder. There was no correlation between psychiatric morbidity and the severity or site of skin disease. Self-report measures of the behavioural impact of skin disease and attitudes to appearance were related to psychological morbidity. Except in subjects without visible skin pathology (5%) there was no evidence that psychiatric illness was an aetiological factor in the development of skin disease. Self-report measures were used to distinguish between those patients in whom psychiatric morbidity was closely related to skin disease (75%), and those in whom it may be coincidental (20%). Psychological care for the former group is most appropriately provided by physicians, who should be encouraged to improve their detection and management of psychiatric morbidity.

Psychiatric Disorder in the General Hospital

1986 ◽  
Vol 149 (2) ◽  
pp. 172-190 ◽  
Author(s):  
Richard Mayou ◽  
Keith Hawton
Keyword(s):  
Psychiatric Disorder ◽  
General Hospital ◽  
Psychiatric Morbidity ◽  
Routine Clinical Practice ◽  
Standard Methods ◽  
Different Types ◽  
Patient Groups ◽  
Hospital Doctors ◽  
The Many

There have been many reports of psychiatric disorder in medical populations, but few have used standard methods on representative patient groups. Even so, there is consistent evidence for considerable psychiatric morbidity in in-patient, out-patient and casualty department populations, much of which is unrecognised by hospital doctors. We require a better classification of psychiatric disorder in the general hospital, improved research measures, and more evidence about the nature and course of the many different types of problem so that we can provide precise advice for their management of routine clinical practice.

Hysterectomy and psychiatric disorder: are the levels of psychiatric morbidity falling?

1995 ◽  
Vol 25 (2) ◽  
pp. 277-283 ◽  
Author(s):  
D. Gath ◽  
N. Rose ◽  
A. Bond ◽  
A. Day ◽  
A. Garrod ◽  
...  
Keyword(s):  
Psychiatric Disorder ◽  
Present State ◽  
Psychotropic Medication ◽  
Psychiatric Morbidity ◽  
Self Report ◽  
Social Characteristics ◽  
Psychiatric History ◽  
State Examination

SynopsisThis paper compares the findings of three studies carried out at intervals over the years 1975–1990. The three studies were concerned with different issues, but each study examined psychiatric morbidity among women undergoing hysterectomy for menorrhagia of benign origin.In all three studies levels of psychiatric morbidity were measured before the operation and 6 months after the operation. Psychiatric morbidity was measured with the Present State Examination (PSE) (Wing et al. 1974), and with established self-report questionnaires. Levels of psychiatric morbidity fell significantly across the three studies. In Study 1, the proportions of psychiatric cases were 58% before hysterectomy and 26% after; in Study 2, 28% before and 7% after; and in Study 3, 9% before and 4% after.The decline in psychiatric morbidity was not associated with demographic and social characteristics, previous psychiatric history, family psychiatric history, the nature of the women's menstrual complaints, or the women's understanding and expectations of the operation.In Study 3 anti-menorrhagic drugs were prescribed twice as frequently as in the two previous studies; while the prescribing of psychotropic medication was significantly higher in Study 1 than in Study 2 or Study 3. The implications of these findings are discussed.

Physicians' Diagnoses of Psychiatric Disorders for People with Chronic Fatigue Syndrome

2002 ◽  
Vol 32 (2) ◽  
pp. 109-124 ◽  
Author(s):  
Susan R. Torres-Harding ◽  
Leonard A. Jason ◽  
Victoria Cane ◽  
Adam Carrico ◽  
Renee R. Taylor
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Chronic Fatigue ◽  
Self Report ◽  
Control Group ◽  
Psychiatric Diagnoses ◽  
Psychiatric Interview ◽  
Fatigue Syndrome

Objective: To examine rates of psychiatric diagnoses given by patients' primary or regular physicians to persons with chronic fatigue syndrome (CFS), persons with psychiatrically explained fatigue, and a control group. Physicians' psychiatric diagnosis and participants' self-reported psychiatric diagnoses were compared to lifetime psychiatric diagnoses as measured by a structured psychiatric interview. Method: Participants were recruited as part of a community-based epidemiology study of chronic fatigue syndrome. Medical records of 23 persons with chronic fatigue syndrome, 25 persons with psychiatrically explained chronic fatigue, and 19 persons without chronic fatigue (controls) were examined to determine whether their physician had given a diagnosis of mood, anxiety, somatoform, or psychotic disorder. Lifetime psychiatric status was measured using the Structured Clinical Interview for the DSM-IV (SCID). Participants' self reports of specific psychiatric disorders were assessed as part of a detailed medical questionnaire. Results: Physicians' diagnosis of a psychiatric illness when at least one psychiatric disorder was present ranged from 40 percent in the psychiatrically explained group, 50 percent in the control group, and 64.3 percent in the CFS group. Participants in the psychiatrically explained group were more accurate than physicians in reporting the presence of a psychiatric disorder, and in accurately reporting the presence of a mood or anxiety disorder. Conclusions: The present investigation found underrecognition of psychiatric illness by physicians, with relatively little misdiagnosis of psychiatric illness. Physicians had particular difficulty assessing psychiatric disorder in those patients whose chronic fatigue was fully explained by a psychiatric disorder. Results emphasized the importance of using participant self report as a screening for psychiatric disorder.

scholarly journals Prevalence of psychiatric disorders for Indigenous Australians: a population-based birth cohort study

2021 ◽  
Vol 30 ◽  
Author(s):  
James M. Ogilvie ◽  
Stacy Tzoumakis ◽  
Troy Allard ◽  
Carleen Thompson ◽  
Steve Kisely ◽  
...  
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Birth Cohort ◽  
Psychiatric Illness ◽  
Hospital Admissions ◽  
Psychiatric Morbidity ◽  
Indigenous Australians ◽  
Psychiatric Diagnoses ◽  
Sociodemographic Characteristics ◽  
Prevalence Rates

Abstract Aims Limited information exists about the prevalence of psychiatric illness for Indigenous Australians. This study examines the prevalence of diagnosed psychiatric disorders in Indigenous Australians and compares this to non-Indigenous Australians. The aims were to: (1) determine prevalence rates for psychiatric diagnoses for Indigenous Australians admitted to hospital; and (2) examine whether the profile of psychiatric diagnoses for Indigenous Australians was different compared with non-Indigenous Australians. Methods A birth cohort design was adopted, with the population consisting of 45 141 individuals born in the Australian State of Queensland in 1990 (6.3% Indigenous). Linked administrative data from Queensland Health hospital admissions were used to identify psychiatric diagnoses from age 4/5 to 23/24 years. Crude lifetime prevalence rates of psychiatric diagnoses for Indigenous and non-Indigenous individuals were derived from the hospital admissions data. The cumulative incidence of psychiatric diagnoses was modelled separately for Indigenous and non-Indigenous individuals. Logistic regression was used to model differences between Indigenous and non-Indigenous psychiatric presentations while controlling for sociodemographic characteristics. Results There were 2783 (6.2%) individuals in the cohort with a diagnosed psychiatric disorder from a hospital admission. The prevalence of any psychiatric diagnosis at age 23/24 years was 17.2% (491) for Indigenous Australians compared with 5.4% (2292) for non-Indigenous Australians. Indigenous individuals were diagnosed earlier, with overrepresentation in psychiatric illness becoming more pronounced with age. Indigenous individuals were overrepresented in almost all categories of psychiatric disorder and this was most pronounced for substance use disorders (SUDs) (12.2 v. 2.6% of Indigenous and non-Indigenous individuals, respectively). Differences between Indigenous and non-Indigenous Australians in the likelihood of psychiatric disorders were not statistically significant after controlling for sociodemographic characteristics, except for SUDs. Conclusions There is significant inequality in psychiatric morbidity between Indigenous and non-Indigenous Australians across most forms of psychiatric illness that is evident from an early age and becomes more pronounced with age. SUDs are particularly prevalent, highlighting the importance of appropriate interventions to prevent and address these problems. Inequalities in mental health may be driven by socioeconomic disadvantage experienced by Indigenous individuals.

Psychiatric morbidity in an Italian general practice

1987 ◽  
Vol 17 (1) ◽  
pp. 243-247 ◽  
Author(s):  
Cesario Bellantuono ◽  
Roberto Fiorio ◽  
Paul Williams ◽  
Patrizia Cortina
Keyword(s):  
General Practice ◽  
Psychiatric Disorder ◽  
Psychiatric Morbidity ◽  
Screening Strategy ◽  
Self Report ◽  
Morbidity Rate ◽  
Second Phase ◽  
Two Stage ◽  
Diagnostic Threshold ◽  
Group B

SynopsisA two-stage screening strategy was applied in a single-handed general practice in northern Italy. The study was designed so that all the second-stage psychiatric interviews were conducted during the first phase of the study (group A patients), while self-report questionnaire (GHQ) and GP assessments only were collected during the second phase (group B patients).The estimated true case rate of psychiatric disorder (36%) did not differ between the two phases of the study, but there were marked differences in the general practitioner's diagnostic behaviour. During the first phase (when psychiatric interviews were being conducted in the practice), her behaviour was heavily biased towards diagnosing psychiatric disorder; 61% of the patients were regarded by her as psychiatric cases and the hidden psychiatric morbidity rate was only 9%. During the second phase of the study (no psychiatric interviews in the practice), only 37% of the patients were regarded as psychiatric cases by the GP, and the hidden morbidity rate was 59%.The results are interpreted as demonstrating that the presence of a psychiatrist conducting a two-stage screening survey in the practice had a profound effect on the diagnostic threshold. They also provide support for the use of the GHQ as a case-finding instrument in general practice.

scholarly journals The relationship between prior psychiatric disorder and chronic fatigue: evidence from a national birth cohort study

2007 ◽  
Vol 38 (7) ◽  
pp. 933-940 ◽  
Author(s):  
S. B. Harvey ◽  
M. Wadsworth ◽  
S. Wessely ◽  
M. Hotopf
Keyword(s):  
Psychiatric Disorder ◽  
Psychiatric Disorders ◽  
Dose Response ◽  
Psychiatric Illness ◽  
Chronic Fatigue ◽  
Self Report ◽  
Personality Factors ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Shared Risk

BackgroundIncreased rates of psychiatric disorder have previously been reported in those diagnosed with chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME), although the direction of causation in this relationship has not been established. We aimed to test the hypothesis that individuals with self-reported CFS/ME have increased levels of psychiatric disorder prior to the onset of their fatigue symptoms.MethodA total of 5362 participants were prospectively followed with various measures of personality, psychiatric disorder and fatigue levels collected over the first 43 years of their life. CFS/ME was identified through self-report during a semi-structured interview at age 53 years.ResultsThirty-four (1.1%) of the 3035 subjects assessed at age 53 years reported a diagnosis of CFS/ME. CFS/ME was more common among females, but there was no association between CFS/ME and either social class, social mobility or educational level. Those with psychiatric illness between the ages of 15 and 36 years were more likely to report CFS/ME later in life with an odds ratio (OR, adjusted for sex) of 2.65 [95% confidence interval (CI) 1.26–5.57, p=0.01]. Increased levels of psychiatric illness, in particular depression and anxiety, were present prior to the occurrence of fatigue symptoms. There was a dose–response relationship between the severity of psychiatric symptoms and the likelihood of later CFS/ME. Personality factors were not associated with a self-reported diagnosis of CFS/ME.ConclusionsThis temporal, dose–response relationship suggests that psychiatric disorders, or shared risk factors for psychiatric disorders, are likely to have an aetiological role in some cases of CFS/ME.

The Reliability of a Survey Psychiatric Assessment Schedule for the Elderly

1980 ◽  
Vol 137 (2) ◽  
pp. 148-162 ◽  
Author(s):  
John Bond ◽  
Patrick Brooks ◽  
Vera Carstairs ◽  
Louise Giles
Keyword(s):  
Psychiatric Disorder ◽  
Elderly People ◽  
Mental State ◽  
Affective Disorders ◽  
Psychiatric Illness ◽  
The Elderly ◽  
Functional Disorders ◽  
Psychiatric Assessment ◽  
At Home

SummaryThe Survey Psychiatric Assessment Schedule (SPAS) was used in a survey of elderly people living at home and in institutions to examine its reliability in determining mental state. A psychiatrist assessed the same subjects using the Geriatric Mental State Schedule (GMSS) and classified psychiatric disorder into three broad groups: organic disorders, schizophrenia and paranoid disorders, and affective disorders and psychoneuroses. The agreement between the psychiatrist's classification of mental state and the classification derived from SPAS was found to be satisfactory for organic disorders and less satisfactory for functional disorders. The limitations of this method of identifying psychiatric illness are examined.

The twelve-month outcome of patients with neurotic illness in general practice

1981 ◽  
Vol 11 (3) ◽  
pp. 535-550 ◽  
Author(s):  
A. H. Mann ◽  
R. Jenkins ◽  
E. Belsey
Keyword(s):  
Social Life ◽  
Function Analysis ◽  
Psychiatric Morbidity ◽  
The Social ◽  
Assessment Measures ◽  
Psychiatric State ◽  
One Year

SYNOPSISOne hundred patients, selected to be representative of those attending general practitioners with non-psychotic psychiatric disorders were followed up for one year. standard assessments of mental state, personality, social stresses and supports were carried out for each patient at the outset and after a year.The outcome for this cohort determined both by the level of psychiatric morbidity at interview after one year and by the pattern of the psychiatric morbidity during the year has been analysed with reference to the assessment measures. Discriminant function analysis indicates that the initial estimate of the severity of the psychiatric morbidity and a rating of the quality of the social life at the time of follow-up are the only factors that significantly predict the psychiatric state after one year. Social measures also predict a pattern of illness charactorized by a rapid recovery after the initial assessemtn. Patients who reported continuous psychiatric morbidity during the year were, older, physically ill and very likely to have recevied psychotropic drugs. Receipt of this medication during the year was associated with initial assessments of abnormality of personality, older age, and a diagnosis of depression.The findings of this study are seen to support a triaxial assessment and classification of non-psychotic psychiatirc disorders, with symptoms, personality and social state being rated independently.

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