Psychiatric symptoms, impaired function, and medical care costs in an HMO setting.

Abstract:

:More information is needed regarding the medical care utilization and costs of individuals who report depressed mood, persistent anxiety, brief anxiety, panic, and trouble controlling violent behavior. We present findings from a 1-year prospective follow-up study of a stratified random sample of adult HMO enrollees (N = 10,377) originally interviewed by telephone. A strong association was observed between these psychiatric symptoms, associated impaired function, and general medical care costs during the year following the interview. After controlling for age, gender, race, medical conditions, and smoking, the mean costs of general medical care were $1,948 for respondents who reported none of the psychiatric symptoms or impaired function: $3,006 for respondents with all 5 symptoms but no impaired function; and $3,906 for those with all 5 symptoms and pervasive functional impairment. Persistent anxiety and depressed mood had the greatest impact on total general medical costs, while impaired function was associated with increased likelihood of hospital admission and emergency room use. We conclude that depressed mood, persistent anxiety, and related impaired function are associated with substantial increases in the use and cost of general medical care.

journal_name

Gen Hosp Psychiatry

authors

Hunkeler EM,Spector WD,Fireman B,Rice DP,Weisner C

doi

10.1016/s0163-8343(03)00018-5

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

178-84

issue

3

eissn

0163-8343

issn

1873-7714

pii

S0163834303000185

journal_volume

25

pub_type

杂志文章
  • Early neuropsychiatric involvement in antiphospholipid syndrome.

    abstract:OBJECTIVE:Neuropsychiatric symptoms may be the main manifestations and very early symptoms of developing autoimmune diseases. Early detection and treatment could reverse psychotic symptoms and restore cognitive function. CASE REPORT:A 24-year-old woman presented with acute psychotic symptoms. Routine physical examinat...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2012.02.005

    authors: Lai JY,Wu PC,Chen HC,Lee MB

    更新日期:2012-09-01 00:00:00

  • Course of hypochondriasis in an international primary care study.

    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

    authors: Simon GE,Gureje O,Fullerton C

    更新日期:2001-03-01 00:00:00

  • Predictors of suicidal ideation one-year post-bariatric surgery: Results from the Toronto Bari-Psych Cohort Study.

    abstract:OBJECTIVE:Previous studies have shown higher rates of death by suicide, suicide attempts, suicidal ideation and non-suicidal self-directed violence (NS-SDV) in bariatric surgery patients. METHODS:Data came from the Toronto Bari-Psych Cohort study of adult patients who underwent bariatric surgery between 2010 and 2016....

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2018.11.007

    authors: Wnuk S,Parvez N,Hawa R,Sockalingam S

    更新日期:2020-01-01 00:00:00

  • A minicomputer approach to consultation-liaison data basing: Pedagog-Admin-CLINFO.

    abstract::Minicomputer systems have been designed for researchers who have no prior computer experience and, therefore, require no computer training, that is, programming knowledge. Such systems allow immediate access to the data, their retrieval, reduction, and analysis, and the retention of direct control over the data base b...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(85)90021-0

    authors: Strain JJ,Norvell CM,Strain JJ,Mueenuddin T,Strain JW

    更新日期:1985-04-01 00:00:00

  • Parents bereaved by infant death: PTSD symptoms up to 18 years after the loss.

    abstract:OBJECTIVE:Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentially traumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic posttraumatic stress dis...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2013.06.006

    authors: Christiansen DM,Elklit A,Olff M

    更新日期:2013-11-01 00:00:00

  • Dementia, mental retardation, and competency to make decisions.

    abstract::The psychiatric literature on competency indicates that a diagnosable psychiatric condition alone does not imply incompetency to make treatment decisions. Nonetheless, it is frequently assumed that individuals who are either mentally retarded or demented are incompetent to make decisions. The authors, focusing on the ...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(88)90060-6

    authors: Kaplan KH,Strang JP,Ahmed I

    更新日期:1988-11-01 00:00:00

  • The use of prescription medication in 239 patients with multiple functional somatic syndromes.

    abstract:OBJECTIVE:To describe the use of prescription drugs and their association with patient characteristics in patients with multiple functional somatic syndromes (FSS) focusing on drugs generally recommended and not recommended in FSS treatment. METHOD:Using data from a national prescription registry, we describe the drug...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2018.02.001

    authors: Agger JL,Fink PK,Gormsen LK,Jensen JS,Schröder A

    更新日期:2018-01-01 00:00:00

  • Implications of two-stage depression screening for identifying persons with thoughts of self-harm.

    abstract:OBJECTIVE:Persons with thoughts of self-harm may need evaluation for suicide risk. We examine the prevalence of thoughts of self-harm and whether persons with thoughts of self-harm are identified when two-stage depression screening is used. METHODS:Data are from the 2005-2010 National Health and Nutrition Examination ...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2013.09.007

    authors: Pratt LA,Brody DJ

    更新日期:2014-01-01 00:00:00

  • Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands.

    abstract:OBJECTIVE:There is widespread concern about access to good quality health care for ethnic minority groups. This study investigates differences between ethnic groups regarding prevalence of anxiety and depression, and adherence to treatment guidelines by family practitioners in urban areas in the Netherlands. METHOD:Da...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2010.04.010

    authors: Fassaert T,Nielen M,Verheij R,Verhoeff A,Dekker J,Beekman A,de Wit M

    更新日期:2010-07-01 00:00:00

  • Ziconotide-induced psychosis: a case report.

    abstract::Ziconotide is used intrathecally in the management of severe chronic pain that contains a warning against neuropsychiatric adverse events. The definition of psychiatric events is broad and management strategies are vague. This case report describes a 49-year-old female who was admitted to the acute psychiatric unit to...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2014.10.001

    authors: Phan SV,Waldfogel JM

    更新日期:2015-01-01 00:00:00

  • Differential diagnosis and treatment of steroid-induced affective syndromes.

    abstract::The differential diagnosis of hypercortisolemia is complex, particularly when the clinician must distinguish Cushing's syndrome (CS) from major depression. The present clinical case history demonstrates that by means of physical and laboratory examinations, the psychiatrist can make the initial differentiation, in con...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章,评审

    doi:10.1016/0163-8343(95)00063-w

    authors: Pies R

    更新日期:1995-09-01 00:00:00

  • Psychological factors associated with severe abuse of the Hemodialysis diet.

    abstract::Thirty-one maintenance hemodialysis patients were observed for a six-month period. Seven of these patients (22.6%) were severe and persistent abusers of the hemodialysis diet. Because there are serious, even lethal, consequences of the sequelae of hemodialysis diet abuse such as fluid overload and/or hyperkalemia, thi...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(81)90052-9

    authors: Procci WR

    更新日期:1981-06-01 00:00:00

  • Reverse liaison rounds with a burn unit case.

    abstract::A liaison rounds is presented, one attended by all members of a consultation-liaison (C-L) team along with the medical director of a burn unit. This structure is designated as a "reverse liaison rounds," as it is the opposite of the conventional liaison meeting, which consists of one C-L consultant and the total nonps...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(88)90087-4

    authors: Billowitz A,Schubert DS

    更新日期:1988-01-01 00:00:00

  • Persistently poor outcomes of undetected major depression in primary care.

    abstract::Despite its relevance for quality care initiatives, the field of psychiatry has little scientific knowledge regarding the course of current major depression when primary care patients with the disorder remain undetected. Using statewide telephone screening, we identified and followed 98 adults with current major depre...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/s0163-8343(97)00095-9

    authors: Rost K,Zhang M,Fortney J,Smith J,Coyne J,Smith GR Jr

    更新日期:1998-01-01 00:00:00

  • The somatization in primary care study: a tale of three diagnoses.

    abstract::Somatization is a common phenomenon that has been defined in many ways. The two most widely used diagnoses, Somatization Disorder (SD) and Abridged Somatization Disorder (ASD), are based on lifetime unexplained symptoms. However, reports indicate instability in lifetime symptom recall among somatizing patients. Multis...

    journal_title:General hospital psychiatry

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0163-8343(02)00247-5

    authors: Dickinson WP,Dickinson LM,deGruy FV,Candib LM,Main DS,Libby AM,Rost K

    更新日期:2003-01-01 00:00:00

  • Substance-induced organic mental disorders. A clinical and conceptual approach.

    abstract::Drug abuse is a prevalent problem in society and often occurs as abuse of multiple substances. The authors present a model for understanding the clinical symptomatology and course of substance-induced organic mental disorders and present a hypothesis that explains how various factors might interact to produce the diso...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(86)90076-9

    authors: Kulick AR,Ahmed I

    更新日期:1986-05-01 00:00:00

  • Pain insensitivity in schizophrenia. Case report and review of the literature.

    abstract::We describe a schizophrenic man whose lack of pain and related objective signs of a perforated small bowel led to a delay in diagnosis and surgical intervention. A review of the literature suggests that both psychodynamic and specific biologic factors can produce atypical presentations in psychotic patients with illne...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(90)90050-m

    authors: Rosenthal SH,Porter KA,Coffey B

    更新日期:1990-09-01 00:00:00

  • Receiving treatment for common mental disorders.

    abstract:OBJECTIVE:Anxiety and depressive disorders are widely prevalent, but patients are only treated in a minority of cases. In this study, the explanation of receiving mental health treatment is sought in predisposing and enabling characteristics and indicators for objective and self-perceived need. METHODS:Cross-sectional...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2008.09.011

    authors: Verhaak PF,Prins MA,Spreeuwenberg P,Draisma S,van Balkom TJ,Bensing JM,Laurant MG,van Marwijk HW,van der Meer K,Penninx BW

    更新日期:2009-01-01 00:00:00

  • The future of consultation-liaison psychiatry and medical-psychiatric units in the era of managed care.

    abstract::There has been increasing recognition and documentation of the impact of psychiatric problems on the outcome and cost of medical care. Because consultation-liaison psychiatrists have the expertise to address the psychiatric aspects of medical illness, this group should be in a strong position to facilitate integration...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章,评审

    doi:10.1016/0163-8343(95)00053-t

    authors: Goldberg RJ,Stoudemire A

    更新日期:1995-07-01 00:00:00

  • Issues in the diagnosis and treatment of adolescents in a general hospital inpatient unit.

    abstract::The treatment of adolescents in a general hospital setting is fraught with difficulty. There are significant limitations to time, space, finances, and the physical plant. There are limitations to the numbers, types, mix of patients with other patients, and the types of treatment available. To deal with these issues, a...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(88)90097-7

    authors: Madow MR

    更新日期:1988-03-01 00:00:00

  • General psychiatry, primary care, and medical primacy.

    abstract::Nonmedical psychotherapists are able to present themselves to the public as psychiatrist-equivalents, except for prescribing drugs, because psychiatrists have neglected to emphasize the nature of medical responsibility, here called "medical primacy." Psychiatric identification with the psychoanalytic and public relati...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(79)90029-x

    authors: Rashkis HA

    更新日期:1979-09-01 00:00:00

  • Complex posttraumatic stress disorder: evidence from the primary care setting.

    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

    authors: Dickinson LM,deGruy FV 3rd,Dickinson WP,Candib LM

    更新日期:1998-07-01 00:00:00

  • Dropping out of outpatient psychiatric treatment: a preliminary report of a 2-year follow-up of 1500 psychiatric outpatients in Kermanshah, Iran.

    abstract:BACKGROUND:Outpatient psychiatric treatment provides both psychotherapy and pharmacotherapy for a large portion of psychiatric patients. Dropping out, or early termination of treatment, may be considered a common barrier to outpatient's psychiatric treatment. There are limited studies on this issue in Iran. The current...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.genhosppsych.2012.10.008

    authors: Khazaie H,Rezaie L,de Jong DM

    更新日期:2013-05-01 00:00:00

  • Psychiatric disorders in hypertrophic cardiomyopathy.

    abstract:OBJECTIVE:Depression is undertreated in cardiac disease. Our aim was to evaluate frequency and risk factors of psychiatric disorders in hypertrophic cardiomyopathy. METHODS:This was a two-phase epidemiological approach, using screening questionnaire then gold standard structured clinical interview. A cohort of 148 pat...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2007.09.005

    authors: Morgan JF,O'Donoghue AC,McKenna WJ,Schmidt MM

    更新日期:2008-01-01 00:00:00

  • Paranoid psychosis induced by consumption of methylenedioxypyrovalerone: two cases.

    abstract::Of growing concern has been the phenomenon of psychoactive chemicals legally marketed as a variety of products such as "bath salts" or "herbal incense." There is little in the formal literature about actual adverse effects of such chemicals. We have two cases of a paranoid psychosis in individuals consuming methylened...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2011.04.010

    authors: Antonowicz JL,Metzger AK,Ramanujam SL

    更新日期:2011-11-01 00:00:00

  • Managing Medicare reimbursement on medical-psychiatry units.

    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

    authors: Goldberg RJ,Simundson S

    更新日期:1991-09-01 00:00:00

  • A pilot study of Brief IPT-A delivered in primary care.

    abstract:OBJECTIVE:The objective was to examine the feasibility, acceptability and preliminary effectiveness of a brief version of Interpersonal Psychotherapy for Depressed Adolescents (BIPT-A) in low-income Latino adolescents treated in an urban pediatric primary care setting. METHOD:Ten adolescents, ages 12 to 19 years, who ...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2015.04.013

    authors: Mufson L,Yanes-Lukin P,Anderson G

    更新日期:2015-09-01 00:00:00

  • Eating disorder symptoms and comorbid psychopathology among male and female veterans.

    abstract:OBJECTIVE:Eating disorder (ED) symptoms have gone mostly unexamined among veterans. The current study assessed rates of bulimia nervosa (BN) and binge eating disorder (BED) symptoms and diagnoses and their associations with common comorbidities among male and female veterans. METHOD:Participants were US military veter...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/j.genhosppsych.2014.03.013

    authors: Litwack SD,Mitchell KS,Sloan DM,Reardon AF,Miller MW

    更新日期:2014-07-01 00:00:00

  • Recognition of emotional distress in physically healthy primary care patients who perceive poor physical health.

    abstract::This study examines the recognition and treatment of emotional distress in physically healthy primary care patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three private primary care practices completed a mental health screening form prior to their medical visit which inc...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(95)00023-k

    authors: Olfson M,Gilbert T,Weissman M,Blacklow RS,Broadhead WE

    更新日期:1995-05-01 00:00:00

  • ER "capture" of the skid-row alcoholic.

    abstract::In response to the spiraling anger and frustration voiced by the emergency room (ER) medical staff and the observed negative interactions between the alcohol-dependent patient and the ER staff, the author completed a 6-month retrospective review of all patients evaluated by the ER service with a complaint of alcohol a...

    journal_title:General hospital psychiatry

    pub_type: 杂志文章

    doi:10.1016/0163-8343(85)90026-x

    authors: Baker FM

    更新日期:1985-04-01 00:00:00