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Physical and psychiatric comorbidity in general practice

S R Kisely1, D P Goldberg

  • 1Department of Psychiatry, Withington Hospital, Manchester.

The British Journal of Psychiatry : the Journal of Mental Science
|August 1, 1996
PubMed
Summary
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Patients with severe physical illness are twice as likely to have psychiatric conditions. Addressing physical and mental health comorbidity in general practice is crucial for patient care.

Area of Science:

  • General Practice
  • Psychiatry
  • Public Health

Background:

  • Physical and psychiatric morbidities often coexist in general practice settings.
  • Understanding the interplay between physical and mental health is vital for comprehensive patient care.

Purpose of the Study:

  • To investigate the association between physical and psychiatric morbidity in primary care patients.
  • To identify factors that may influence this relationship.

Main Methods:

  • A two-stage study involving 1620 general practice patients.
  • Screening with the General Health Questionnaire (GHQ-12) and interviews using the Composite International Diagnostic Instrument (CIDI-PHC), Brief Disability Questionnaire (BDQ), and Groningen Social Disability Schedule (GSDS).
  • Assessment of physical and psychiatric morbidity by both researchers and general practitioners (GPs).

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Main Results:

  • A significant association exists between physical and psychiatric morbidity, particularly in patients with five or more somatic symptoms.
  • Patients with severe physical illness were twice as likely to have psychiatric conditions.
  • Female gender, social disability, and physical disability were associated with psychiatric disorder, independent of age.

Conclusions:

  • Moderate to severe physical morbidity increases the risk of psychiatric illness in general practice.
  • Psychiatric symptoms tend to be more severe when co-occurring with medical illness.
  • The high prevalence of physical and psychiatric comorbidity necessitates greater attention to the specific needs of these patients.