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The effect of physical ill health on the course of psychiatric disorder in general practice

Published online by Cambridge University Press:  03 January 2018

S. R. Kisely  and
D. P. Goldberg
S. R. Kisely*
Affiliation:
Department of Psychiatry, Withington Hospital, Manchester
D. P. Goldberg
Affiliation:
Department of Psychiatry, Withington Hospital, Manchester
*
Dr S. Kisel, Mental Health Commissioning Team, Birmingham Health Authority, I Vernon Road, Edgbaston, Birmingham BI6 9SA
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Abstract

Background

The aim of this study was to determine the effect of physical morbidity on the outcome of patients with psychiatric disorder, and to compare the effects of non-medically and medically explained symptoms.

Method

One hundred and fifty psychiatric cases were recruited using a two-stage design from 1620 consecutive patients attending their GP. Subjects were assessed at the time of screening, and one year subsequently, 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 GPs.

Results

Medically explained somatic symptoms were strongly related to psychological outcome one year later. Whereas just over a half of patients with no medically explained symptoms had recovered from a psychiatric disorder, the percentage recovery fell to 41% in those with 1 −4 medically explained symptoms, and only 21% in patients with five or more medically explained symptoms.

Conclusions

Physical ill-health has been shown to make an independent contribution to psychological outcome. The specific needs of these patients should receive greater attention.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 6 , June 1997 , pp. 536 - 540
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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