scholarly journals Somatoform disorders in general practice

2004 ◽  
Vol 184 (6) ◽  
pp. 470-476 ◽  
Author(s):  
Margot W M. De Waal ◽  
Ingrid A. Arnold ◽  
Just A. H. Eekhof ◽  
Albert M. Van Hemert
Keyword(s):  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Depressive Disorders ◽  
Somatoform Disorders ◽  
Functional Limitations ◽  
Physical Symptoms ◽  
Diagnostic Interview ◽  
Choice Of Treatment ◽  
Mild Impairment

BackgroundGeneral practitioners play a pivotal part in the recognition and treatment of psychiatric disorders. Identifying somatoform disorders is important for the choice of treatment.AimsTo quantify the prevalence of, and functional impairment associated with, somatoform disorders, and their comorbidity with anxiety/depressive disorders.MethodTwo-stage prevalence study: a set of questionnaires was completed by 1046 consecutive patients of general practitioners (aged 25–80 years), followed by a standardised diagnostic interview (SCAN 2.1).ResultsThe prevalence of somatoform disorders was 16.1% (95% CI 12.8-19.4). When disorders with only mild impairment were included, the prevalence increased to 21.9%. Comorbidity of somatoform disorders and anxiety/depressive disorders was 3.3 times more likely than expected by chance. In patients with comorbid disorders, physical symptoms, depressive symptoms and functional limitations were additive.ConclusionsOur findings underline the importance of a comprehensive diagnostic approach to psychiatric disorders in general practice.

Psychiatric disorders in adolescents in primary care

1998 ◽  
Vol 173 (6) ◽  
pp. 508-513 ◽  
Author(s):  
Tami Kramer ◽  
M. Elena Garralda
Keyword(s):  
Primary Care ◽  
General Practice ◽  
General Practitioner ◽  
Psychiatric Disorders ◽  
Health Risks ◽  
Physical Symptoms ◽  
Global Assessment Scale ◽  
Scale Scores ◽  
Research Interviews ◽  
Internalising Disorders

BackgroundLittle is known about psychiatric disorders in adolescents who attend primary care.MethodProspective study of 13- to 16-year-olds consecutively attending general practice. Information was obtained from adolescents, parents and general practitioners, using questionnaires and research interviews.Results136/200 (68%) of adolescent attenders took part. Two per cent presented with psychiatric complaints. From research interviews with adolescents, psychiatric disorder in the previous year was found in 38%, with moderate impairment of functioning in over half (according to Children's Global Assessment Scale scores). Most disorders (42/50, 84%) were emotional (‘internalising’) disorders. Psychiatric disorders were significantly associated with high levels and intensity of physical symptoms and with increased health risks. General practitioner assessment of psychiatric disorders was low on sensitivity (20.8%) but high on specificity (90.7%). Doctors identified most severely affected adolescents.ConclusionsDepressive and anxiety disorders are common among adolescent general practice attenders and linked to increased physical symptoms; general practitioner recognition is limited.

scholarly journals Risk of miscarriage in women with psychiatric disorders

2021 ◽  
pp. 1-6
Author(s):  
Maria C. Magnus ◽  
Alexandra Havdahl ◽  
Nils-Halvdan Morken ◽  
Knut-Arne Wensaas ◽  
Allen J. Wilcox ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Depressive Disorders ◽  
Somatoform Disorders ◽  
Psychiatric Diagnoses ◽  
Schizophrenia Spectrum Disorders ◽  
Birth Registry ◽  
Increased Risk ◽  
Wide Range

Background Some psychiatric disorders have been associated with increased risk of miscarriage. However, there is a lack of studies considering a broader spectrum of psychiatric disorders to clarify the role of common as opposed to independent mechanisms. Aims To examine the risk of miscarriage among women diagnosed with psychiatric conditions. Method We studied registered pregnancies in Norway between 2010 and 2016 (n = 593 009). The birth registry captures pregnancies ending in gestational week 12 or later, and the patient and general practitioner databases were used to identify miscarriages and induced abortions before 12 gestational weeks. Odds ratios of miscarriage according to 12 psychiatric diagnoses were calculated by logistic regression. Miscarriage risk was increased among women with bipolar disorders (adjusted odds ratio 1.35, 95% CI 1.26–1.44), personality disorders (adjusted odds ratio 1.32, 95% CI 1.12–1.55), attention-deficit hyperactivity disorder (adjusted odds ratio 1.27, 95% CI 1.21–1.33), conduct disorders (1.21, 95% CI 1.01, 1.46), anxiety disorders (adjusted odds ratio 1.25, 95% CI 1.23–1.28), depressive disorders (adjusted odds ratio 1.25, 95% CI 1.23–1.27), somatoform disorders (adjusted odds ratio 1.18, 95% CI 1.07–1.31) and eating disorders (adjusted odds ratio 1.14, 95% CI 1.08–1.22). The miscarriage risk was further increased among women with more than one psychiatric diagnosis. Our findings were robust to adjustment for other psychiatric diagnoses, chronic somatic disorders and substance use disorders. After mutual adjustment for co-occurring psychiatric disorders, we also observed a modest increased risk among women with schizophrenia spectrum disorders (adjusted odds ratio 1.22, 95% CI 1.03–1.44). Conclusions A wide range of psychiatric disorders were associated with increased risk of miscarriage. The heightened risk of miscarriage among women diagnosed with psychiatric disorders highlights the need for awareness and surveillance of this risk group in antenatal care.

A Study of the Use of Antidepressant Medication in General Practice

1974 ◽  
Vol 125 (585) ◽  
pp. 186-192 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Present Author ◽  
Antidepressant Medication ◽  
Undergraduate Teaching ◽  
Specific Information ◽  
Clinical Expertise ◽  
Prescribing Habits ◽  
Treatment Of Depression

Several surveys (Carstairs and Bruhn, 1962; Shepherd et al., 1966; and Johnson, 1973a) have demonstrated that the treatment of psychiatric disorders in general practice consists principally of prescribing drugs, with relatively little use of social agencies and psychotherapy. Although Shepherd et al. (1966) comment that the treatment is often haphazard and inadequate, the published surveys of general practice give little specific information about the prescribing habits of doctors. The present author surveyed the prescribing habits of general practitioners in the treatment of depression in the belief that it is necessary to have this information in order to evaluate the need for education in this clinical expertise, and also to act as a comparison for other surveys which will undoubtedly be carried out in the future to test the effectiveness of the current expansion of undergraduate teaching in psychiatry.

Self-rated general health and psychiatric disorders in a general population sample

2005 ◽  
Vol 20 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Ulrich John ◽  
Christian Meyer ◽  
Hans-Jürgen Rumpf ◽  
Anja Schumann ◽  
Horst Dilling ◽  
...  
Keyword(s):  
General Population ◽  
Psychiatric Disorders ◽  
General Health ◽  
Somatoform Disorders ◽  
Population Sample ◽  
Participation Rate ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Diagnostic And Statistical Manual

AbstractThe purpose of this study was to explore the relationships between nicotine and alcohol dependence, depressive, anxiety and somatoform disorders with self-rated general health (GH). A cohort study of a random sample of the non-institutionalised general population aged 18–64 with a participation rate of 70.2% was carried out in a German area (n = 4075 at baseline). A follow-up of tobacco smokers or heavy drinkers (n = 1083, 79.4% of those who had given consent to be followed-up) was conducted 30 months after baseline measurement. The assessments included self-ratings of GH and Diagnostic and Statistical Manual (DSM-IV) diagnoses based on the Composite International Diagnostic Interview. The results show that nicotine dependence, anxiety disorders and somatoform disorders moderately predicted self-rated GH at follow-up (general linear model, R2 = 0.12). We conclude that psychiatric disorders may contribute to the prediction of a low self-rated GH.

Idiopathic Physical Symptoms: A Common Manifestation of Psychiatric Disorders in Primary Care

CNS Spectrums ◽  
2006 ◽  
Vol 11 (3) ◽  
pp. 201-210 ◽  
Author(s):  
Javier I. Escobar ◽  
Angelica Dìaz-Martínez ◽  
Michael Gara
Keyword(s):  
Primary Care ◽  
Mental Disorders ◽  
Psychiatric Disorders ◽  
Somatoform Disorders ◽  
Common Mental Disorders ◽  
Psychiatric Patients ◽  
Physical Symptoms ◽  
Medical Specialties ◽  
Assessment And Treatment ◽  
Medically Unexplained

ABSTRACTWorldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the “somatic component” has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of “fashionable” labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate “somatoform disorders” category. These efforts fall short, and revisionists are asking altogether for the elimination of “somatoform disorders” from future nomenclatures.This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.

The diagnostic stability of ICD-10 psychiatric diagnoses in clinical practice

1997 ◽  
Vol 12 (3) ◽  
pp. 136-139 ◽  
Author(s):  
TK Daradkeh ◽  
OEF El-Rufaie ◽  
YO Younis ◽  
R Ghubash
Keyword(s):  
Psychiatric Disorders ◽  
United Arab Emirates ◽  
Depressive Disorders ◽  
Psychotic Disorders ◽  
Somatoform Disorders ◽  
Temporal Stability ◽  
Diagnostic System ◽  
Bipolar Disorders ◽  
Diagnostic Stability ◽  
Icd 10

SummaryThis study examines the stability of ICD-10 diagnoses of patients admitted to Al Ain (United Arab Emirates) inpatients psychiatric unit during the period from November 1993 to August 1995. Diagnostic stability is a measure of the degree to which diagnoses remained unchanged at a later hospital admission. One hundred and seven patients were admitted more than once during this period, accounting for 168 readmissions. High levels of diagnostic stability were found for ICD-10 Fl-psychiatric disorders (100%), F2-schizophrenia (87%), F3-bipolar disorders (87%) and F3-depressive disorders (73%). A poor level of stability was found for patients with neurotic, stress related and adjustment disorders (F4), ranging from zero for somatoform disorders to 50% for generalized anxiety and panic disorders. Poor levels of stability were also found for other psychoses (excluding schizophrenia and affective psychoses) and personality disorders. We conclude that the introduction of ICD-10 as a formal diagnostic system has greatly improved the temporal stability of the most commonly encountered psychiatric disorders (ICD-10 Fl to F3 disorders), confirming the construct validity of those psychiatric disorders. Further investigations are required to evaluate the diagnostic stability of neurotic and other psychotic disorders.

scholarly journals Psychiatric disorders and other health dimensions among Holocaust survivors 6 decades later

2009 ◽  
Vol 195 (4) ◽  
pp. 331-335 ◽  
Author(s):  
Asaf Sharon ◽  
Itzhak Levav ◽  
Jenny Brodsky ◽  
Annarosa Anat Shemesh ◽  
Robert Kohn
Keyword(s):  
Psychiatric Disorders ◽  
Sleep Disturbances ◽  
Depressive Disorders ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Holocaust Survivor ◽  
Post Traumatic Stress ◽  
The Holocaust ◽  
Use Of Services ◽  
Health Related

BackgroundNo previous community-based epidemiological study has explored psychiatric disorders among those who survived the Holocaust.AimsTo examine anxiety and depressive disorders, sleep disturbances, other health problems and use of services among individuals exposed and unexposed to the Holocaust.MethodThe relevant population samples were part of the Israel World Mental Health Survey. The interview schedule included the Composite International Diagnostic Interview and other health-related items.ResultsThe Holocaust survivor group had higher lifetime (16.1%; OR = 6.8, 95% CI 1.9–24.2) and 12-month (6.9%; OR = 22.5, 95% CI 2.5–204.8) prevalence rates of anxiety disorders, and more current sleep disturbances (62.4%; OR = 2.5, 95% CI 1.4–4.4) and emotional distress (P<0.001) than their counterparts, but did not have higher rates of depressive disorders or post-traumatic stress disorder.ConclusionsEarly severe adversity was associated with psychopathological disorder long after the end of the Second World War, but not in all survivors. Age during the Holocaust did not modify the results.

Child and Adolescent Psychiatry in General Practice

2001 ◽  
Vol 35 (3) ◽  
pp. 308-314 ◽  
Author(s):  
Elena Garralda
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Mental Health Problems ◽  
Child And Adolescent ◽  
Health Problems ◽  
Undergraduate Teaching ◽  
Further Development

Objective: This review discusses the role of general practitioners and primary care health staff in the assessment, treatment and prevention of child and adolescent psychiatric disorders and to consider implications for service delivery. Method: Literature review. Papers were selected as having an empirical evidence base or as describing and documenting new initiatives in general practice. Results: A small proportion of about 3% of children present to general practice with behavioural or emotional problems, but psychiatric disorders in the context of somatic presentations are considerably more common. They are probably higher than in the general population reflecting an increased tendency by children with disorders to consult. Recognition by general practitioners is limited and few children with disorders are referred to specialist clinics. However, referrals are mostly appropriate: the more severely affected children in difficult psychosocial circumstances. A number of pilot studies have shown the feasibility and potential usefulness of setting up shifted specialist clinics in primary care and of training primary care doctors and other staff in the recognition or management of child mental heath problems. Conclusion: Primary care is an appropriate resource to help increase attention to child and adolescent mental health problems. Its potential requires further development and rigorous evaluation. Areas lending themselves to development include: improved medical undergraduate teaching and postgraduate training; suitable information and advice-giving on child mental health problems by the primary care team; the development of specific child and adolescent psychiatric interventions for use in the primary care setting; careful and discriminating development of shifted outpatient clinics for selected child psychiatric disorders; the development of focused protocols for referral to specialist services; further development of mental health promotion clinics in primary care.

scholarly journals Somatoform disorders in the development of visceral systems pathology

2019 ◽  
pp. 40-50
Author(s):  
Yu. Yu. Golubev ◽  
A. E. Lychkova ◽  
A. E. Severin ◽  
V. I. Torshin ◽  
Yu. P. Starshinov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Irritable Bowel Syndrome ◽  
Chronic Heart Failure ◽  
Arterial Hypertension ◽  
Depressive Disorders ◽  
Somatoform Disorders ◽  
Physical Symptoms ◽  
The Body ◽  
High Prevalence ◽  
Irritable Bowel

Introduction. Somatoform disorder (vegetative dysfunction), which occurs against the background of endocrine changes in the body during adolescence, is clinically inadequate vegetative regulation. Up to 50 percent of patients with primary care have physical symptoms that can not be explained by the general health status. In recent years, much attention has been paid to the problem of somatoform disorders in hypertension, chronic heart failure (CHF). There is a high prevalence of anxiety-depressive disorders, especially in patients with CHF. Unexplained symptoms of somatoform disorders often lead to more frequent visits to doctors, unnecessary visits to the clinic and laboratory tests or costly and potentially dangerous invasive procedures. The aim is to study autonomic dysfunction in patients with chronic heart failure and anxiety-depressive disorders and electrophysiological aspects of somatization of pathology in irritable bowel syndrome (IBS). Material and methods. The study was conducted in 35 patients with somatoform disorders in irritable bowel syndrome accompanied by severe abdominal pain. The study involved 25 patients with a functional class of chronic heart failure (CHF) NYHA II-III against a background of arterial hypertension (AH) of ischemic origin and 30 patients with arterial hypertension of II degree and abdominal obesity (AO). Results. All patients showed signs of anxiety-depressive or somatoform disorders, asthenia. The presence of signs of anxiety and depressive disorders in patients with CHF and AH was accompanied by violations of autonomic regulation of blood pressure level, activity of the sympathetic nervous system, frequent occurrence of cardiac arrhythmias, decreased tolerance to physical activity and deterioration of the quality of life of this category of patients. The IBS was studied by electromyography. In the descending part of the colon, an increase in the frequency and amplitude of slow waves was observed, and the power of contraction was increased to 3 times. Conclusions. Imbalance of the sympathetic / parasympathetic systems in favor of the sympathetic part of the ANS contributes to worsening of the compromised function of the vascular endothelium. These changes significantly increase the risk of developing a lethal outcome of acute myocardial infarction. The high prevalence and the associated increase in morbidity and mortality make it necessary to continue research into the regulation of regulation of somatoform disorders in chronic heart failure.

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