Co-occurrence of psychiatric and medical morbidity in primary care.

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.