The Relationship of Psychiatric, Psychosomatic and Organic Illness in a General Practice

¹ Medical Research Council, Clinical Psychiatry Research Unit, Graylingwell Hospital, Chichester, Sussex, University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan.
² The Caversham Centre, London, N.W.5, University of Sussex, Student Health Service, Falmer, Brighton, Sussex.

1. An investigation was undertaken to test the hypothesis that somatic and psychiatric illness tend to occur in the same individuals more frequently than by chance. The term "illness" was taken to refer to pathology rather than to consultation.

2. The population studied was 124 women and 115 men, who represented an approximately 30 per cent. random sample of patients continuously attending one general practitioner for a minimum period of 7 years (average 14 years), within the age range of 15 to 6o.

3. A classification for the entries in the patients' health records was devised, comprising six categories (major organic, minor organic, psychiatric, probably psychosomatic, possibly psychosomatic illness, plus a symptomatic category). A diagnosis entered under one of these categories scored only one "point" no matter how frequently the patient presented with symptoms referrable to that disorder. Repeat analyses on 26 records showed the scheme to be reasonably reliable.

4. The findings were analysed by a method which controlled both for age and length of period of observation. For psychiatric and major organic illness, a negative association was found for men and none for women, with the doubtful exception among the latter of those between 21 and 30 years of age. These findings could well be due to chance. Associations were also found between psychosomatic, minor organic and symptomatic complaints, which were interpreted as probably due to a low threshold of complaint. It was concluded that the hypothesis of a positive concordance between the varieties of physical and mental illness had not been confirmed.

5. The relevant literature has been briefly discussed, with particular emphasis on method.