Abstract:
:The validity and clinical use of a recently developed instrument to assess health care needs of patients with a physical illness, called INTERMED, is investigated. The INTERMED combines data reflecting patients' biological, psychological, and social characteristics with information on health care utilization characteristics. An example of a patient population in which such an integral assessment can contribute to the appropriateness of care, are patients with low back pain of degenerative or unknown origin. It supports the validity and the clinical usefulness of the INTERMED when clinically relevant subgroups in this heterogeneous population can be identified and described based on their INTERMED scores. The INTERMED was utilized in a group of patients (N = 108) having low back pain who vary on the chronicity of complaints, functional status, and associated disability. All patients underwent a medical examination and responded to a battery of validated questionnaires assessing biological, psychological, and social aspects of their life. In addition, the patients were assessed by the INTERMED. It was studied whether it proved to be possible to form clinically meaningful groups of patients based on their INTERMED scores; for this, a hierarchical cluster analysis was performed. In order to clinically describe them, the groups of patients were compared with the data from the questionnaires. The cluster analysis on the INTERMED scores revealed three distinguishable groups of patients. Comparison with the questionnaires assessing biological, psychological, and social aspects of disease showed that one group can be characterized as complex patients with chronic complaints and reduced capacity to work who apply for a disability compensation. The other groups differed explicitly with regard to chronicity, but also on other variables. By means of the INTERMED, clinically relevant groups of patients can be identified, which supports its use in clinical practice and its use as a method to describe case mix for scientific or health care policy purposes. In addition, the INTERMED is easy to implement in daily clinical practice and can be of help to ease the operationalization of the biopychosocial model of disease. More information on its validity in different patient populations is necessary.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Stiefel FC,de Jonge P,Huyse FJ,Guex P,Slaets JP,Lyons JS,Spagnoli J,Vannotti Mdoi
10.1016/s0163-8343(98)00061-9subject
Has Abstractpub_date
1999-01-01 00:00:00pages
49-56issue
1eissn
0163-8343issn
1873-7714pii
S0163834398000619journal_volume
21pub_type
杂志文章abstract::Psychiatric morbidity among 240 pregnant women attending an antenatal unit was assessed by a two-stage screening procedure, using the General Health Questionnaire (GHQ-30) and Present State Examination Schedule (PSE). The prevalence of psychiatric morbidity was found to be significantly associated with younger age (< ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(93)90109-2
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:Missed appointments are associated with poorer health outcomes. We predicted that compared to secure attachment style, fearful and dismissing attachment styles would be associated with greater number of missed primary care visits in patients with diabetes. METHODS:In patients with diabetes from nine health m...
journal_title:General hospital psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1016/j.genhosppsych.2005.07.004
更新日期:2006-01-01 00:00:00
abstract::A number of reports have suggested that some cases of multiple personality disorder might be due to temporal lobe epileptic discharges. We have administered a structured interview, the Dissociative Disorders Interview Schedule, to 20 subjects with multiple personality disorder, 20 with complex partial seizures, and 28...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(89)90026-1
更新日期:1989-01-01 00:00:00
abstract::Preoperative risk factors of postoperative delirium were evaluated in 260 patients admitted for open heart surgery. The incidence of delirium was 11.5%. Independent predictors included cognitive impairment, atrial fibrillation, a history of peripheral vascular disease major depression and advanced age. Aforementioned ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2006.08.007
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:Intimate partner violence (IPV) is a common form of violence experienced by pregnant women and is believed to have adverse mental health effects postnatally. This study investigated the association of postnatal depression (PND) and suicidal ideation with emotional, physical and sexual IPV experienced by wo...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2015.10.005
更新日期:2016-01-01 00:00:00
abstract::Hypochondriasis is frequently defined as a chronic condition distinct from anxiety and depressive disorders. Consecutive primary care attenders (n=25,916) were screened using the General Health Questionnaire and a stratified random sample (n=5447) completed a baseline diagnostic assessment. All patients with significa...
journal_title:General hospital psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1016/s0163-8343(01)00115-3
更新日期:2001-03-01 00:00:00
abstract::Additional psychiatric disorders in eating disorders patients may contribute to the risk of suicide and suicide attempts. The aim of this study was to examine associations between Axes I and II comorbidity and suicidality in a large sample of women currently suffering from an eating disorder (ED). In a sample of 288 w...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2003.10.005
更新日期:2004-03-01 00:00:00
abstract::Catatonia is a rare syndrome that occurs in mood and psychotic disorders, and general medical conditions. Postpartum depression affects 10%-15% of women within 6 months after delivery. Postpartum psychosis affects 0.1%-0.5% of women within weeks after delivery, though it can occur within hours; it carries risk for sui...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2011.11.010
更新日期:2012-07-01 00:00:00
abstract::Barriers to clear communication, such as culture, language, and other aspects of self-presentation may have an important impact on the doctor-patient relationship. When not addressed, cultural and linguistic issues can result in unreliable clinical histories, noncompliance with medical treatment, misinterpretation of ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(03)00065-3
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:The objectives of this study were to examine associations between depressive symptoms and body mass over 1 year during early adolescence and to assess how the associations might differ depending upon whether self-reported or directly measured height and weight were used. METHOD:Participants were 446 sixth-gr...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2008.06.008
更新日期:2008-09-01 00:00:00
abstract::A 29-year-old single Puerto Rican woman with AIDS was admitted to the Medical Service for pneumonia, seen by the Psychiatric Consultation Service, an eventually transferred to the Inpatient Psychiatric Unit with several possible psychiatric diagnoses including major depression, HIV dementia, delirium, and posttraumati...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(94)90119-8
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:This study investigated pediatrician-reported practices in identifying, assessing, and treating traumatic exposure and posttraumatic stress disorder (PTSD) in children. METHOD:Focus groups guided the development of a survey that was mailed to primary care pediatricians in Massachusetts in 2005. Descriptive s...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2008.07.008
更新日期:2008-11-01 00:00:00
abstract::We assessed differences in the referral rates of African-American and Caucasian elderly for geropsychiatric consultation. Reasons for referral, assigned diagnoses, and interventions made were also compared. A retrospective chart review of psychiatric consultations was completed for patients aged 65 years and older for...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(97)00004-2
更新日期:1997-05-01 00:00:00
abstract:INTRODUCTION:Chemical restraint is controversial. Appropriate use is ill-defined and chemical restraint may be overutilized. During the period of an unrelated observational study for patients with acute psychomotor agitation in a psychiatric emergency service, we noticed a significant reduction in the number of involun...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2006.06.001
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To settle the best cutoffs for inventories to diagnose depression in chronic hepatitis C (CHC) patients. METHOD:Seventy-five CHC patients were assessed using a standard psychiatric interview (Mini International Neuropsychiatric Interview) to establish Diagnostic and Statistical Manual of Mental Disorders, Fo...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2011.09.002
更新日期:2012-01-01 00:00:00
abstract::Evaluation of the incidence of depression among cancer patients has been the object of a number of studies. Recent reports of medically ill patients have indicated that depression is related to several dimensions of abnormal illness behavior (e.g., hypochondriasis, irritability, denial, disease conviction). To investi...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(89)90135-7
更新日期:1989-11-01 00:00:00
abstract::Appreciation of the role of milieu in psychiatry has waxed and waned in response to various scientific, ideologic, and social pressures. In this review, historical trends in the use of environment in treatment of mental illness are integrated with social science and empirical research studies of milieu. While the insi...
journal_title:General hospital psychiatry
pub_type: 杂志文章,评审
doi:10.1016/0163-8343(82)90030-5
更新日期:1982-04-01 00:00:00
abstract::The interrater reliability and validity of brief interview rated measures of psychosocial adjustment were examined in four sequential studies. A total of 25 videotaped interviews with cancer patients were rated by 105 social workers, nurses, physicians, and specialists in psychosocial oncology. The Rating of Psychosoc...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(81)90048-7
更新日期:1981-06-01 00:00:00
abstract::Forty consecutive patients with disabling tinnitus were interviewed using a structured psychiatric interview and were asked to complete the Hopkins Symptom Checklist (SCL-90), the Chronic Illness Problem Inventory, and the Revised Ways of Coping Checklist. They were compared to a control group of 14 patients attending...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(88)90037-0
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:To investigate longitudinal associations of burnout with heart rate variability (HRV) in patients after their first events of acute coronary syndrome (ACS). METHODS:In total, two hundred eight patients participated in this one-year follow-up study. On the day before discharge, their personal burnout level wa...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2018.05.008
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:We describe a patient with prodromal dementia with Lewy bodies (DLB) presenting with drug-induced visual hallucinations (VHs). CASE REPORT:A 78-year-old woman complained of daytime recurrent VHs characterized by seeing her face and arms covered in fur and viewing moustaches on her daughter's face. VHs starte...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2013.02.005
更新日期:2013-11-01 00:00:00
abstract::Many general hospitals are confronting issues of financial strain precipitated to a large extent by Medicare payment reductions. The viability of psychiatry programs within general hospitals more than ever depends upon some demonstration of their financial as well as clinical contribution. The aim of this study is to ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(91)90035-u
更新日期:1991-09-01 00:00:00
abstract::Alcohol use disorders (AUDs) are common among inpatients in general hospitals and often cause excess mortality. This study investigates the prevalence of AUDs among nonpsychiatric inpatients in one general hospital and evaluates the ability of medical staff to identify such morbidity. A two-phase case-identification s...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2004.01.001
更新日期:2004-05-01 00:00:00
abstract::Among the most important adverse effects of antipsychotics is abnormal glucose metabolism, which includes not only hyperglycemia but hyperinsulinemia and hypoglycemia. We have previously described five patients who experienced hypoglycemia during treatment with antipsychotics. Thus, an anamnesis of gastric surgery, wh...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2015.03.012
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between alcohol use routinely reported during outpatient mental healthcare visits and short-term risk of subsequent suicide attempt. METHODS:Using a longitudinal retrospective-cohort design, electronic health records identified adult outpatient visits to a mental health provider (...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2019.12.002
更新日期:2020-01-01 00:00:00
abstract::Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginni...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(98)00021-8
更新日期:1998-07-01 00:00:00
abstract::The Ras-Raf-mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) kinase (MEK)-ERK cascade is important in the intra-cellular transduction of neurotransmitters, such as dopamine and glutamate. Sorafenib (Nexavar), a multi-kinase inhibitor targeting Raf kinase, vascular endothelial growth factor ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2012.03.001
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Rural populations remain underserved in terms of psychiatric services. This study assesses changes over time in the utilization of telepsychiatric services by individual primary care providers (PCPs) and clinics in rural areas, specifically: (a) types of referrals for telepsychiatry service; (b) PCPs' know...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2006.05.009
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS:Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subj...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2018.03.007
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVE:The goal of this analysis was to examine the effect of benzodiazepine use during pregnancy on maternal and neonatal outcomes in a cohort of women with psychiatric disorders. METHODS:794 evaluable women from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications were follow...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2018.05.010
更新日期:2018-01-01 00:00:00