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Characteristics Of Patients Assigned Multiple Nonthreatening Medical Diagnoses.

Robert J. Gregory1

  • 1Department of Psychiatry, SUNY Upstate Medical University, Syracuse, N.Y.

Primary Care Companion to the Journal of Clinical Psychiatry
|March 12, 2004
PubMed
Summary

Patients with multiple nonthreatening medical diagnoses show distinct psychosocial traits and healthcare use compared to those with threatening diagnoses. Psychosocial factors appear to influence the assignment of nonthreatening diagnoses.

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Area of Science:

  • Medical diagnosis classification
  • Psychosomatic medicine
  • Healthcare utilization research

Background:

  • Medical diagnoses can be categorized by 1-year mortality risk as "threatening" or "nonthreatening" using the Charlson Comorbidity Index (CCI).
  • Understanding psychosocial characteristics and healthcare utilization in patients with multiple nonthreatening diagnoses is crucial for comprehensive care.

Purpose of the Study:

  • To investigate the psychosocial characteristics and medical utilization patterns of general medical outpatients with multiple nonthreatening diagnoses.
  • To compare these patterns with those of patients having multiple threatening diagnoses.

Main Methods:

  • A study involving 125 general medical outpatients receiving psychiatric consultation.
  • Utilized blinded reviews of medical charts, psychological assessments, and billing records to gather data.

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  • Assessed psychosocial factors, somatization, and various healthcare utilization metrics.

    • Main Results:

    • The number of nonthreatening diagnoses correlated significantly with age, somatoform disorder, somatosensory amplification, and ambulatory/emergency visits.
    • Nonthreatening diagnoses did not correlate with Charlson Comorbidity Index (CCI) scores or hospitalizations.
    • Threatening diagnoses (CCI) correlated with age and all medical utilization measures, including hospitalization, but not with somatization indicators.

    Conclusions:

    • Patients with multiple nonthreatening diagnoses exhibit different psychosocial profiles and healthcare utilization compared to those with multiple threatening diagnoses.
    • The link between numerous nonthreatening diagnoses and somatization suggests psychosocial influences on diagnostic assignment.