Physical symptoms in outpatients with psychiatric disorders consulting the general internal medicine division at a Japanese university hospital

Abstract

Purpose

General practitioners have an important role in diagnosing a variety of patients, including psychiatric patients with complicated symptoms. We evaluated the relationship between physical symptoms and psychiatric disorders in general internal medicine (GIM) outpatients in a Japanese university hospital.

Materials and methods

We coded the symptoms and diagnoses of outpatients from medical documents using the International Classification of Primary Care, second edition (ICPC-2). The participants were new outpatients who consulted the GIM outpatient division at Jichi Medical University Hospital in Tochigi, Japan from January–June, 2012. We reviewed all medical documents and noted symptoms and diagnoses. These were coded using ICPC-2.

Results

A total of 1,194 participants were evaluated, 148 (12.4%) of whom were diagnosed as having psychiatric disorders. The prevalence of depression, anxiety disorder, and somatization was 19.6% (number [n] =29), 14.9% (n=22), and 14.2% (n=21), respectively, among the participants with psychiatric disorders. The presence of several particular symptoms was associated with having a psychiatric disorder as compared with the absence of these symptoms after adjusting for sex, age, and the presence of multiple symptoms (odds ratio [OR] =4.98 [95% confidence interval {CI}: 1.66–14.89] for palpitation; OR =4.36 [95% CI: 2.05–9.39] for dyspnea; OR =3.46 [95% CI: 1.43–8.36] for tiredness; and OR =2.99 [95% CI: 1.75–5.13] for headache).

Conclusion

Not only the psychiatric symptoms, but also some physical symptoms, were associated with psychiatric disorders in GIM outpatients at our university hospital. These results may be of help to general practitioners in appropriately approaching and managing patients with psychiatric disorders.

Keywords:

• physical symptoms
• psychiatric disorders
• university hospital
• International Classification of Primary Care 2nd edition

Acknowledgments

Ayako Noda, Takashi Sekiguchi, Takeshi Tanabe, Reiko Yamamoto, Shinichi Uchida, and Hidehiko Kamiyama contributed to the acquisition of data. We thank John Gelblum for his critical reading of the manuscript.

Author contributions

YI contributed to the conception and design of the study, the acquisition of data, the analysis and interpretation of data, and the writing and revision of the manuscript; TT, JM, SI, and MM contributed to the conception and design of the study, interpretation of data, and the writing and revision of the manuscript. All authors approved the final version of the manuscript.

Disclosure

The authors report no conflicts of interest in this work.