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 Psychiatryjournal_title
General hospital psychiatryauthors
Hunkeler EM,Spector WD,Fireman B,Rice DP,Weisner Cdoi
10.1016/s0163-8343(03)00018-5subject
Has Abstractpub_date
2003-05-01 00:00:00pages
178-84issue
3eissn
0163-8343issn
1873-7714pii
S0163834303000185journal_volume
25pub_type
杂志文章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
更新日期:2012-09-01 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: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
更新日期:2020-01-01 00:00:00
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
更新日期:1985-04-01 00:00:00
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
更新日期:2013-11-01 00:00:00
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
更新日期:1988-11-01 00:00:00
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
更新日期:2018-01-01 00:00:00
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
更新日期:2014-01-01 00:00:00
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
更新日期:2010-07-01 00:00:00
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
更新日期:2015-01-01 00:00:00
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
更新日期:1995-09-01 00:00:00
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
更新日期:1981-06-01 00:00:00
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
更新日期:1988-01-01 00:00:00
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
更新日期:1998-01-01 00:00:00
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
更新日期:2003-01-01 00:00:00
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
更新日期:1986-05-01 00:00:00
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
更新日期:1990-09-01 00:00:00
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
更新日期:2009-01-01 00:00:00
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
更新日期:1995-07-01 00:00:00
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
更新日期:1988-03-01 00:00:00
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
更新日期:1979-09-01 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: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
更新日期:2013-05-01 00:00:00
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
更新日期:2008-01-01 00:00:00
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
更新日期:2011-11-01 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: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
更新日期:2015-09-01 00:00:00
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
更新日期:2014-07-01 00:00:00
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
更新日期:1995-05-01 00:00:00
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
更新日期:1985-04-01 00:00:00