Psychiatric symptomatology in an outpatient neurology clinic.
The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive first-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000523:psychology*; D009462:Neurology; D010044:Outpatient Clinics, Hospital; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D010555:Personality Inventory; D011570:Psychiatry; D012017:Referral and Consultation
D000929:Antidepressive Agents, Tricyclic