TY - JOUR
KW - Adult
KW - Aged
KW - Diagnosis, Differential
KW - Female
KW - Health Status
KW - Humans
KW - Interviews as Topic
KW - Male
KW - Mental Disorders/diagnosis/physiopathology
KW - Middle Aged
KW - Midwestern United States
KW - Primary Health Care
KW - Questionnaires
KW - Rural Population
KW - Somatoform Disorders/diagnosis
AU - N. H. Rasmussen
AU - M. E. Bernard
AU - W. S. Harmsen
A1 - 
AB - RATIONALE, AIMS AND OBJECTIVES: There is a robust association between physical symptoms and mental distress, but recognition rates of psychiatric disorders by primary care doctors are low. We investigated patient-reported physical symptoms as predictors of concurrent psychiatric disorders in rural primary care adult outpatients. METHOD: A convenience sample of 1092 patients were assessed with a two-stage diagnostic system consisting of a brief screening questionnaire and a clinician-administered semi-structured interview that linked common physical symptoms with the concurrent presence of psychiatric disorders. RESULTS: Somatoform physical symptoms were highly predictive of the concurrent presence of a psychiatric disorder, with odds ratios ranging from 10.4 (fainting spells) to 54.6 (shortness of breath). Aggregate analysis of somatoform and non-somatoform symptoms relative to no physical symptom produced odds ratios of 3.0 or higher for headaches, chest pain, dizziness, sleep problem, shortness of breath, tired or low energy, and fainting spells. As the number of symptoms (especially somatoform) increased, the odds of a psychiatric disorder increased. CONCLUSION: Although individual physical symptoms are valid triggers for suspecting a psychiatric disorder, the most powerful correlates are total number of physical complaints and somatoform symptom status.
BT - Journal of evaluation in clinical practice
C5 - Medically Unexplained Symptoms
CP - 3
CY - England
DO - 10.1111/j.1365-2753.2007.00879.x
IS - 3
JF - Journal of evaluation in clinical practice
N2 - RATIONALE, AIMS AND OBJECTIVES: There is a robust association between physical symptoms and mental distress, but recognition rates of psychiatric disorders by primary care doctors are low. We investigated patient-reported physical symptoms as predictors of concurrent psychiatric disorders in rural primary care adult outpatients. METHOD: A convenience sample of 1092 patients were assessed with a two-stage diagnostic system consisting of a brief screening questionnaire and a clinician-administered semi-structured interview that linked common physical symptoms with the concurrent presence of psychiatric disorders. RESULTS: Somatoform physical symptoms were highly predictive of the concurrent presence of a psychiatric disorder, with odds ratios ranging from 10.4 (fainting spells) to 54.6 (shortness of breath). Aggregate analysis of somatoform and non-somatoform symptoms relative to no physical symptom produced odds ratios of 3.0 or higher for headaches, chest pain, dizziness, sleep problem, shortness of breath, tired or low energy, and fainting spells. As the number of symptoms (especially somatoform) increased, the odds of a psychiatric disorder increased. CONCLUSION: Although individual physical symptoms are valid triggers for suspecting a psychiatric disorder, the most powerful correlates are total number of physical complaints and somatoform symptom status.
PP - England
PY - 2008
SN - 1365-2753; 1356-1294
SP - 399
EP - 406
EP - 
T1 - Physical symptoms that predict psychiatric disorders in rural primary care adults
T2 - Journal of evaluation in clinical practice
TI - Physical symptoms that predict psychiatric disorders in rural primary care adults
U1 - Medically Unexplained Symptoms
U2 - 18373579
U3 - 10.1111/j.1365-2753.2007.00879.x
VL - 14
VO - 1365-2753; 1356-1294
Y1 - 2008
ER -