title: Improvements in Somatic Complaints Among Individuals With Serious Mental Illness Receiving Treatment in a Psychiatric Hospital.
abstract: Individuals with serious mental illness (SMI) experience significant comorbid somatic complaints. Little is known about response to integrated inpatient care that addresses psychiatric and general medical needs among individuals with SMI.
  
  
  
  Latent growth curve analyses were used to model somatic symptom trajectories across adult inpatients with SMI (n = 989). The Patient Health Questionnaire-15 (PHQ-15) was administered at admission, every 14 days, and at discharge.
  
  
  
  Patients evidenced substantial reduction in somatization from admission (mean [standard deviation] = 9.0 [5.2]) to discharge (mean [standard deviation] = 5.2 [4.4]), with large effects (d = 0.83, 95% confidence interval = 0.76-0.90). Results indicate nonlinear improvement in somatic symptoms for 8 weeks of treatment, with greatest symptom reduction occurring during the first weeks of treatment with continued, albeit slowed, improvement until discharge. Initial PHQ-15 scores were lower among men and those who reported regular exercise in the 30 days preceding this hospitalization. In addition, presence of an anxiety disorder or personality disorder at admission; history of trauma, a gastrointestinal disorder, or major medical illness (within the past 3 months); and significant sleep disturbance independently contribute to higher PHQ-15 scores at admission. A substance use disorder and sleep disturbance were associated with greater immediate symptom reduction.
  
  
  
  Somatic complaints can be managed in the context of inpatient psychiatric care integrated with 24-hour nursing and internal medicine specialists. Addressing psychiatric impairments, improving sleep, and ensuring abstinence from drugs and alcohol are associated with significant improvement in somatic complaints.
authors: From The Menninger Clinic (Madan, Osborne, Walker, Frueh, Allen, Oldham, Fowler), Houston, Texas; Menninger Department of Psychiatry & Behavioral Sciences (Madan, Walker, Allen, Oldham, Fowler), Baylor College of Medicine, Houston, Texas; Department of Psychology (Clapp), University of Wyoming, Laramie, Wyoming; and Department of Psychology (Frueh), University of Hawaii, Hilo, Hawaii.
authors: Alok
authors: A
authors: Madan
authors: Joshua
authors: J
authors: Clapp
authors: Patricia
authors: P
authors: Osborne
authors: Cory
authors: C
authors: Walker
authors: B Christopher
authors: BC
authors: Frueh
authors: Jon
authors: J
authors: Allen
authors: John
authors: J
authors: Oldham
authors: J Christopher
authors: JC
authors: Fowler
mesh_terms: D000328:Adult; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013001:Somatoform Disorders / Q000453:epidemiology / Q000628:therapy*