Kessler L G, Tessler R C, Nycz G R
J Fam Pract. 1983 Feb;16(2):319-24.
This study examines the co-occurrence of psychiatric and medical morbidity in primary care patients utilizing a health care clinic in Marshfield, Wisconsin. Previous research has shown that individuals with psychiatric disorders have higher rates of medical illness than people without psychiatric illness, but most prior studies have tended to confound the measures of psychiatric and medical morbidity. In addition, appropriate controls for bias resulting from different medical utilization patterns have sometimes been absent. The present study reports the medical diagnoses of persons who had been assessed for psychiatric disorder with a standardized psychiatric interview using research diagnostic criteria independent of their medical assessment. Psychiatric diagnoses are analyzed in relation to medical diagnoses at the time of the interview and for a one-year period--six months before and six months after that date. The results indicate that persons with mental disorder diagnoses have significantly more morbidity for the one-year study period. Although considerable congruence exists in the physical diagnoses recorded for both groups, those with mental disorders are more likely to have diagnoses of the digestive and genitourinary systems. Some sex differences are also explored.
本研究利用威斯康星州马什菲尔德的一家医疗诊所，对初级保健患者中精神疾病与躯体疾病的共病情况进行了调查。先前的研究表明，患有精神疾病的个体比没有精神疾病的人患躯体疾病的几率更高，但大多数先前的研究往往混淆了精神疾病和躯体疾病的测量方法。此外，有时缺乏对不同医疗使用模式导致的偏差的适当控制。本研究报告了那些使用独立于其医疗评估的研究诊断标准，通过标准化精神科访谈进行精神疾病评估的患者的医疗诊断情况。精神科诊断根据访谈时以及访谈日期前六个月和后六个月这一为期一年的时间段内的医疗诊断进行分析。结果表明，在为期一年的研究期间，患有精神障碍诊断的人有明显更多的疾病。尽管两组记录的身体诊断存在相当大的一致性，但患有精神障碍的人更有可能被诊断出患有消化系统和泌尿生殖系统疾病。还探讨了一些性别差异。
