|
Researchers from the University of Heidelberg set out to define the basic elements that could detect the presence of psychiatric comorbidities in patients who came to a medical clinic. Using a series of structured interviews and other assessments they studied 357 patients (68% female and mean age of 43) from several general and internal medicine practices.
They came up with 18 indicators of which they believe that 4 were strong and significant predictors of co-existing psychiatric problems in these patients. These are: a screening question for nervousness, anxiety, or worries, a screening question for depressed mood, the self-report of three or more bothersome physical symptoms, and feeling distressed by partner difficulties. The combined assessment of the four predictors resulted in positive predictive values as high as 100%, negative predictive values as high as 91%, sensitivities as high as 86%, and specificities as high as 100%. The study is published in the current Psychosomatic Medicine journal.
One of the authors (Kroenke) recently published a related article in International Journal of Methods Psychiatric Research which described that over 30% of somatic symptoms are medically unexplained. He points out that "unexplained or multiple somatic symptoms are strongly associated with coexisting depressive and anxiety disorders." Other factors that predict psychiatric co-morbidity include recent stress, lower self-rated health and higher somatic symptom severity, as well as high healthcare utilization, difficult patient encounters as perceived by the physician, and chronic medical disorders.
Wayne Katon, MD from the University of Washington School of Medicine in Seattle has studied the psychiatric/medicine interface for over two decades. One of his recent most articles discusses the relationships between major depression, depressive symptoms, and general medical illness.
10:37:10 PM 
|
|
