TY - JOUR
AU - M. Olfson
AU - R. Lewis-Fernandez
AU - M. M. Weissman
AU - A. Feder
AU - M. J. Gameroff
AU - D. Pilowsky
AU - M. Fuentes
A1 - 
AB - OBJECTIVE: The authors� goals were to estimate the prevalence of psychotic symptoms among adults attending an urban general medical practice that serves a low-income population and to describe the mental health, social and occupational functioning, and mental health treatment of these patients. METHOD: Data were drawn from a recent study of adult primary care patients (N=1,005) in a large, urban, university-affiliated general medicine practice. During a medical visit, patients completed the psychotic disorders section of the Mini International Neuropsychiatric Interview, the Primary Care Evaluation of Mental Disorders, a drug use disorders screen, the Sheehan Disability Scale, and a questionnaire that probed demographic characteristics, health status, and mental health treatment. RESULTS: Two hundred ten (20.9%) patients reported one or more psychotic symptoms, most commonly auditory hallucinations. There was an inverse correlation between family income and the prevalence of psychotic symptoms and a positive association between prevalence and Hispanic ethnicity. Compared with patients without psychotic symptoms, patients with psychotic symptoms were significantly more likely to have major depression (42.4% versus 12.6%), panic disorder (24.8% versus 4.0%), generalized anxiety disorder (38.6% versus 8.4%), and alcohol use disorder (12.9% versus 5.0%). They were also more likely to report current suicidal ideation (20.0% versus 3.5%), recent work loss (55.0% versus 35.6%), and marital distress (28.6% versus 13.0%). Approximately one-half of the patients with psychotic symptoms (47.6%) had taken a prescribed psychotropic medication during the last month. CONCLUSIONS: Psychotic symptoms were highly prevalent in this primary care practice. These patients were at risk for several common mental disorders and often reported impaired work and social functioning. Future research should clarify the extent to which psychotic symptom reports among Hispanic patients are affected by culturally patterned idioms of distress. Clinicians who work in primary care practices that serve low-income patient populations should routinely inquire about psychotic symptoms.
BT - The American Journal of Psychiatry
C5 - Healthcare Disparities
CP - 8
DO - 10.1176/appi.ajp.159.8.1412
IS - 8
JF - The American Journal of Psychiatry
N2 - OBJECTIVE: The authors� goals were to estimate the prevalence of psychotic symptoms among adults attending an urban general medical practice that serves a low-income population and to describe the mental health, social and occupational functioning, and mental health treatment of these patients. METHOD: Data were drawn from a recent study of adult primary care patients (N=1,005) in a large, urban, university-affiliated general medicine practice. During a medical visit, patients completed the psychotic disorders section of the Mini International Neuropsychiatric Interview, the Primary Care Evaluation of Mental Disorders, a drug use disorders screen, the Sheehan Disability Scale, and a questionnaire that probed demographic characteristics, health status, and mental health treatment. RESULTS: Two hundred ten (20.9%) patients reported one or more psychotic symptoms, most commonly auditory hallucinations. There was an inverse correlation between family income and the prevalence of psychotic symptoms and a positive association between prevalence and Hispanic ethnicity. Compared with patients without psychotic symptoms, patients with psychotic symptoms were significantly more likely to have major depression (42.4% versus 12.6%), panic disorder (24.8% versus 4.0%), generalized anxiety disorder (38.6% versus 8.4%), and alcohol use disorder (12.9% versus 5.0%). They were also more likely to report current suicidal ideation (20.0% versus 3.5%), recent work loss (55.0% versus 35.6%), and marital distress (28.6% versus 13.0%). Approximately one-half of the patients with psychotic symptoms (47.6%) had taken a prescribed psychotropic medication during the last month. CONCLUSIONS: Psychotic symptoms were highly prevalent in this primary care practice. These patients were at risk for several common mental disorders and often reported impaired work and social functioning. Future research should clarify the extent to which psychotic symptom reports among Hispanic patients are affected by culturally patterned idioms of distress. Clinicians who work in primary care practices that serve low-income patient populations should routinely inquire about psychotic symptoms.
PY - 2002
SP - 1412
EP - 1419
EP - 
T1 - Psychotic symptoms in an urban general medicine practice.
T2 - The American Journal of Psychiatry
TI - Psychotic symptoms in an urban general medicine practice.
U1 - Healthcare Disparities
U2 - 12153836
U3 - 10.1176/appi.ajp.159.8.1412
VL - 159
Y1 - 2002
ER -