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 multidisciplinary pain clinic as an alternative means of addressing somatic symptoms and psychiatric disorders in an ambulatory medical population. The multidisciplinary pain clinic offers advantages in terms of reimbursement, patient acceptance, and opportunities for interdisciplinary research. The pain clinic model has disadvantages that include administration by departments other than psychiatry, traditional location in a tertiary care hospital, and limitations to who can be treated. However, it offers a place where both the physiological and psychological aspects of somatic symptoms may be addressed. The pain clinic nurtures the priorities and goals of primary care for a patient population whose complexities may outstrip the resources of a single primary care physician.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Sullivan MDdoi
10.1016/0163-8343(93)90005-9subject
Has Abstractpub_date
1993-11-01 00:00:00pages
375-80issue
6eissn
0163-8343issn
1873-7714pii
0163-8343(93)90005-9journal_volume
15pub_type
杂志文章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：: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：OBJECTIVE:This study examined age group differences in the rates of depression diagnosis and treatment using a national probability sample. METHODS:Using data from the 2012 National Ambulatory Medical Care Survey (n=62,723 visits by patients aged 18+ years), we used bivariate and multivariable binary logistic regressi...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2016.08.002
更新日期：2016-01-01 00:00:00
abstract：:Family systems theory provides the physician with a comprehensive paradigm to investigate the social and interpersonal context of physical illness. All physical illnesses, particularly life-threatening and chronic ones, profoundly affect the family life of the patient, and the changed family circumstances in turn have...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(90)90003-u
更新日期：1990-11-01 00:00:00
abstract：:This study examines 100 consecutive patient referrals from a general medical clinic to psychiatric social work. While much has been written from a theoretical or anecdotal perspective on the contribution of social work to medical care, there have been relatively few attempts to look in detail at actual practices. Of t...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(84)90074-4
更新日期：1984-04-01 00:00:00
abstract：OBJECTIVE:To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment. METHODS:Sixty-two participants hospitalized for high-risk obstet...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.011
更新日期：2014-11-01 00:00:00
abstract：OBJECTIVE:The distinction between acute and chronic suicidality is important, because interventions designed to address acute suicidality can worsen chronic suicidality, resulting in an escalating cycle of suicide threats, suicide attempts, and futile hospitalizations. Though most chronically suicidal borderline person...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2020.08.014
更新日期：2020-01-01 00:00:00
abstract：:Although dialysis discontinuation is the second leading "cause" of death among individuals who are maintained with chronic dialysis, little attention is accorded in the literature to patient ambivalence with this crucial decision. Three cases are presented of clinical situations involving termination of dialysis and a...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/s0163-8343(96)00091-6
更新日期：1996-11-01 00:00:00
abstract：:Detection of nonpsychotic morbidity in primary care patients presenting with nonspecific and somatic symptoms has been difficult because of several factors related to the patients, primary care clinicians, and working conditions of the over-crowded clinic. The available standardized screening questionnaires do not ove...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(91)90021-n
更新日期：1991-03-01 00:00:00
abstract：:The paper examines the evidence regarding the extent to which differences exist in health and mental health status of psychiatric patients treated in the specialty mental health, general medical, and informal care sectors. Differences in types of patients treated in the three sectors are important to identify since th...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(90)90032-8
更新日期：1990-01-01 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：:This article illustrates how a mandatory consult procedure identified treatable psychiatric problems. Using a computerized data-based format, 372 (37.4%) patients (the "judgment" group) of 996 psychiatric consultations were identified as referred to assess the patient's capacity to execute a consent form for a medical...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90074-x
更新日期：1985-07-01 00:00:00
abstract：OBJECTIVE:We examined the association between panic disorder (PD), physician-diagnosed cardiac disease (CD), and the interaction of these variables in relation to health care utilization, as measured by emergency department (ED) visitations, in an epidemiologic sample. METHODS:Subjects were identified from the Nationa...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.03.006
更新日期：2007-07-01 00:00:00
abstract：OBJECTIVE:This study examined mental health needs, receptivity to psychosocial aftercare, and barriers to care among survivors of violence-related facial injuries. METHODS:Face-to-face interviews were conducted with 25 consecutively treated individuals at a hospital-based specialty outpatient clinic one month after a ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2006.10.008
更新日期：2007-03-01 00:00:00
abstract：:Persistent somatization patients put a serious burden on the health care system with multiple admissions, tests, surgeries, and medications. This study reports on factors relevant to the health-seeking behavior of somatizing patients and aspects of the health care system that facilitate their overutilization of health...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(93)90035-m
更新日期：1993-07-01 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:The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. METHOD:Participants completed measures of pain location, pain inte...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2007.12.004
更新日期：2008-03-01 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：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：OBJECTIVE:Patients with factitious disorder (FD) fabricate illness, injury or impairment for psychological reasons and, as a result, misapply medical resources. The demographic and clinical profile of these patients has yet to be described in a sufficiently large sample, which has prevented clinicians from adopting an ...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2016.05.002
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:We investigated the influence of race/ethnicity in diagnostic and disposition decision-making for children and adolescents presenting to an urban psychiatric emergency service (PES). METHOD:Medical records were reviewed for 2991 child and adolescent African-American, Hispanic/Latino and white patients, treat...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.01.003
更新日期：2008-05-01 00:00:00
abstract：:The psychosocial skills of 24 PGY I medical residents receiving psychiatric training every other week during the internship year were evaluated and compared to a control group of 13 PGY I residents. After the internship year, the psychiatrically trained residents showed an increase in their ability to recognize emotio...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(86)90088-5
更新日期：1986-03-01 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：: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:Thyroid dysfunction is common during pregnancy and the postpartum period and is known to cause psychiatric disturbances. A woman with Graves' disease and psychosis in the postpartum period is described. METHODS:A 22-year-old woman with Graves' disease developed fluctuating orientation, catatonia, delusions o...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.003
更新日期：2014-11-01 00:00:00
abstract：:Interviews with patients and staff of the New York Hospital Burn Unit in which they discuss their reactions to a variety of unit milieu stresses were videotaped. These were then edited together and played back at staff conference. This intervention increased staff awareness of unit stresses, facilitated discussion abo...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(86)90058-7
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVES:Patients with acute-on-chronic liver failure (ACLF) experience long-term chronic liver diseases plus an acute liver function decompensation. This study aimed to determine whether psychological symptoms in patients with hepatitis B virus (HBV)-related ACLF differ from those with other chronic liver diseases a...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.11.012
更新日期：2012-05-01 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：BACKGROUND:Adolescent depression has been shown to be associated with later development of obesity. The purpose of this study was to examine the association between depressive symptoms and obesity with progressive pubertal development. METHODS:We conducted an analysis of the association between depressive symptoms and...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2006.03.007
更新日期：2006-07-01 00:00:00
abstract：:This study reports DSM-III diagnoses and demographic characteristics of 100 patients consecutively referred to a university hospital consultation-liaison service for evaluation of medically unexplained symptoms suggesting physical disorders. Thirty-seven percent of patients received diagnoses of somatoform, dissociati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90006-4
更新日期：1985-01-01 00:00:00
