title: Toward defining the scope of psychosomatic medicine practice: psychosomatic medicine in an outpatient, tertiary-care practice setting.
abstract: BACKGROUND
  Because psychosomatic medicine (PM) is increasingly practiced in outpatient settings, the scope of practice needs to be delineated from community psychiatry and inpatient psychiatry work.
  
  
  OBJECTIVE
  The authors sought to address the question of whether outpatient activities are a definably part the scope of practice of PM.
  
  
  METHODS
  Three clinical groups were compared: 200 PM outpatients, 200 consultation-liaison (CL) inpatients, and 200 community-psychiatry (CP) outpatients.
  
  
  RESULTS
  The groups differed significantly in 49 of 112 demographic and clinical comparisons (43.8%). Analysis of individual measures validated the concept that PM outpatient practice requires traditional PM/CL expertise with medical-psychiatric differential diagnosis, unexplained physical symptoms, pain, and psychopharmacological management in medically ill and geriatric patients.
  
  
  CONCLUSIONS
  Outpatient PM experiences may also enhance training opportunities, given an expanded case-mix.
authors.affiliation: Dept. of Psychiatry, Mayo Clinic, 990 Riverwood Lane SW, Oronoco, MN 55960, USA. rundell.james@mayo.edu
authors.forename: James R
authors.initials: JR
authors.lastname: Rundell
authors.forename: Kierin
authors.initials: K
authors.lastname: Amundsen
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Rummans
authors.forename: Gayla
authors.initials: G
authors.lastname: Tennen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000379:methods / Q000706:statistics & numerical data; D015897:Comorbidity; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data*; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D011611:Psychosomatic Medicine / Q000193:education / Q000379:methods* / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055815:Young Adult