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 of medical and psychiatric services in managed care delivery systems. Although consultation-liaison psychiatry (CLP) has documented its ability to shorten inpatient medical lengths of stay for some disorders, a greater challenge exists in developing comprehensive systems to identify and care for patients with mental health problems in primary care settings. This paper reviews the fiscal and programmatic implications for managed medical care systems of findings from outcome-based C-L research. The future role of CLP and combined medical-psychiatric units in an era of managed care is also discussed.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Goldberg RJ,Stoudemire Adoi
10.1016/0163-8343(95)00053-tsubject
Has Abstractpub_date
1995-07-01 00:00:00pages
268-77issue
4eissn
0163-8343issn
1873-7714pii
016383439500053Tjournal_volume
17pub_type
杂志文章,评审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::The present study aims to validate the Spanish version of the Hospital Anxiety and Depression Scale (HADS) and to determine the use of this tool for screening mood and anxiety disorders. Psychometric properties of the HADS were assessed in different groups of general medical outpatients attending the Hospital Clínic i...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(03)00043-4
更新日期:2003-07-01 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:Integrating primary care services into specialty mental health clinics has been proposed as a method for improving health care utilization for medical conditions by adults with serious mental illness. This paper examines the impact of a mental health based primary care program on emergency department (ED) vis...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2018.02.008
更新日期:2018-01-01 00:00:00
abstract::Hyperthyroidism has profound effects on mental health. The literature is sparse, however, with regard to suicide attempts related to untreated hyperthyroidism. This case report illustrates the presentation of a patient in the intensive care unit after a life-threatening Tylenol overdose presumed to be secondary to adj...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2012.12.006
更新日期:2013-09-01 00:00:00
abstract::In this study, 96 frequent attender patients in primary care were compared with 466 other primary care patients. The focus was on psychiatric morbidity, current and former psychiatric treatment, and self-perceived need for treatment. The prevalence of psychiatric illness was much greater among frequent attender patien...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(94)00059-m
更新日期:1995-01-01 00:00:00
abstract::Outpatient consultation-liaison (C-L) psychiatry has been beset with problems concerning funding and patient acceptance. Though the consultation, liaison, and referral clinic models for outpatient C-L psychiatry each offer advantages, they have not conquered these fundamental problems. This paper introduces the multid...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(93)90005-9
更新日期:1993-11-01 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:BACKGROUND:Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). OBJECTIVES:The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. DESIGN:PTSD at 30 months after the SARS ou...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2010.07.007
更新日期:2010-11-01 00:00:00
abstract::This study describes and evaluates the adequacy of sociodemographic and clinical descriptors as potential predictors of unplanned discharge from and completion of psychiatric day treatment programs. A 2-year retrospective chart review was completed on all patients (N = 327) attending three university-affiliated day tr...
journal_title:General hospital psychiatry
pub_type: 杂志文章,多中心研究
doi:10.1016/s0163-8343(97)00052-2
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:To characterize the US national level healthcare utilization patterns of patients with commercial insurance plans before and after a psychiatric hospitalization admitted through the emergency department (ED) using insurance claims data. METHOD:We identified 34,250 patients from multiple commercial health ins...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2020.10.001
更新日期:2020-01-01 00:00:00
abstract::A randomized and prospective study examined the effects of intensive communication between treatment providers on physician behavior and patient care using a representative sample of patients referred to a German psychosomatic consultation-liaison (C-L) service (1998-1999). Sixty-seven patients were grouped (ICD-10) a...
journal_title:General hospital psychiatry
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.genhosppsych.2004.08.005
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:The objective was to assess the association between asthma and depressive symptoms (DS) and to evaluate the relationship between DS and risk factors [smoking, physical inactivity, body mass index (BMI) and sleep duration] in asthmatic individuals. METHODS:We analyzed data from the Israeli National Health Int...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2011.09.007
更新日期:2012-01-01 00:00:00
abstract::The occurrence of malignant catatonia in pregnancy is a psychiatric emergency. In this article, we present the case of a pregnant woman with a first psychotic episode with catatonic features, autonomic abnormalities and elevated creatinine phosphokinase levels in the context of a severe adverse reaction to antipsychot...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2006.10.003
更新日期:2007-01-01 00:00:00
abstract::Linkages between psychiatry and other medical specialties have become increasingly evident over the past decade. Reinstatement of the medical internship for psychiatric trainees, expansion of psychiatric liaison services, growth of general hospital psychiatric units, determination of the extensive role served by nonps...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2013.12.011
更新日期:2014-05-01 00:00:00
abstract::Advancing medical technology presents problems to medical professionals previously unforeseen. Psychiatric consultants are frequently called upon to assist staff, patients, and families in addressing these issues. The nursing staff of an infant intensive care unit was surveyed as to their perceptions of their work and...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(89)90037-6
更新日期:1989-05-01 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::Bone marrow transplantation offers new hope for cure in a variety of leukemias, aplastic anemia, and other immunodeficiency and hematologic disorders. But the psychologic circumstances accompanying this procedure are often profoundly stressful. The evolution of consultation--liaison services on a bone marrow transplan...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(88)90006-0
更新日期:1988-09-01 00:00:00
abstract::We report that infertile women in Japan as well as in the Western world have high levels of emotional distress, anxiety, and depression. The reasons for anxiety and depression in infertile women are easy to presume but remain unclear. We conducted the present study to assess the relationship between the anxiety and de...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2004.05.002
更新日期:2004-09-01 00:00:00
abstract::Clinical observation had suggested that mild depression occurs after admission for acute medical treatment and then decreases during further hospitalization for rehabilitation treatment. The Geriatric Depression Scale (GDS) was given on admission and discharge to 14 stroke and 17 amputee rehabilitation patients. Each ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(92)90039-d
更新日期:1992-03-01 00:00:00
abstract::A 48-year-old woman with head and neck pain and upper extremity weakness demonstrated equivocal neurologic findings and otherwise essentially negative laboratory and x-ray evaluations. An interview at a case conference revealed significant depression, severe marital discord, and a poor self-image. The correlation of t...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(80)90087-0
更新日期:1980-12-01 00:00:00
abstract::A structured interview, ADDIS (Alkohol Drog Diagnos InStrument), designed to assess substance use disorders, was included as a part of the intake protocol in a department of orthopedics at a general hospital. To evaluate both the effectiveness and feasibility of the new procedure, the attitudes of 29 staff members wer...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(96)00088-6
更新日期:1997-01-01 00:00:00
abstract::The authors surveyed 356 family medicine residency training directors to determine the role of psychiatrists in family medicine training. Two hundred five responses were received, covering the training experiences of 3696 residents. Psychiatrists were actively involved in the training programs, but their role was circ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(83)90111-1
更新日期:1983-07-01 00:00:00
abstract::We performed a randomized trial to prevent depression relapse in primary care by evaluating intervention effects on medication attitudes and self-management of depression. Three hundred and eighty six primary care patients at high risk for recurrent depression were randomized to receive a 12-month intervention. Interv...
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(03)00074-4
更新日期:2003-09-01 00:00:00
abstract::Eating disorders like bulimia nervosa, generally considered to be rare in Asian countries, are currently on the rise among the youth, probably secondary to rapid westernization and globalization of the orient. Clinical manifestations of these disorders, which were previously thought to be different in the oriental cou...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2014.05.006
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:The use of cell phones and short message service (SMS, also called "texting") has become pervasive in Western society and increasingly throughout the world. Despite the importance of this technology in everyday life, little is known about how patients draw on SMS to keep in contact with family and friends dur...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2012.03.006
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the extent of health care utilisation (excluding costs) of diabetic patients with and without depressive symptoms attending a specialist clinic in Singapore. METHODS:A total of 537 Asian outpatients (aged 21 years and above) who were attending a Diabetes Centre were...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2009.01.001
更新日期:2009-05-01 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:OBJECTIVE:To describe a patient with behavioral variant frontotemporal dementia (bvFTD) presenting with impulse control disorders (ICDs) which responded to fluvoxamine and topiramate. CASE REPORT:A 64-year-old woman was affected by several ICDs. At disease onset, she suffered from impulsive smoking and overeating whic...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2014.06.005
更新日期:2014-11-01 00:00:00