Past mental health or substance use treatment history and psychiatric differential diagnosis in consultation-liaison patients.
The purpose of this study was to determine whether frequencies of any current primary or secondary (organic) psychiatric diagnoses in consultation-liaison (C-L) patients are associated with patient report of past history of mental health or substance use disorder treatment. Clinical information recorded in 134 C-L patients was retrospectively analyzed with the chi-square test, two-tailed, or Fisher's Exact Test when the sample sizes were < or = 5. The results revealed that the overall likelihood of the existence of a secondary psychiatric disorder diagnosis is elevated when there is no treatment history (P = 0.009). A primary psychiatric disorder is more likely to be diagnosed when there is treatment history (P = 0.009). Specific psychiatric diagnoses more likely to be present when there is no treatment history are organic mood disorder, depressed (P = 0.020) and adjustment disorder (P = 0.010). Specific diagnoses more likely to be present when there is treatment history are psychoactive substance-withdrawal syndrome (P = 0.014) and alcohol abuse or dependence (P = 0.028). The authors conclude that psychiatric treatment history can help C-L psychiatrists with differential diagnostic considerations.
Rundell
J R
JR
Department of Psychiatry, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland 20814-4799, USA.
Hall
R C
RC
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry; D012017:Referral and Consultation; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis; D019966:Substance-Related Disorders / Q000175:diagnosis*