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Published Online: 1 October 2011

Service Use Among Patients With Serious Mental Illnesses Who Presented With Physical Symptoms at Intake

Abstract

Objective:

The goal of this study was to examine relationships among serious mental illness, general physical symptoms, and use of mental health services among persons presenting for admission at a community-based mental health center.

Methods:

Number and type of physical symptoms were assessed during the routine intake process. Individuals (N=1,022) were screened by phone with a modified version of the Physical Health Questionnaire-15. Diagnostic, demographic, and treatment information was tracked prospectively. Data were analyzed for 682 individuals who kept at least one appointment. Analyses examined associations among physical symptoms, diagnosis, and service use over time.

Results:

A total of 481 patients (71%) reported three or more physical symptoms. Patients with three or more physical symptoms were significantly older (p<.013), were more likely to be female (p<.001) and Spanish speaking (p<.05), and used significantly more services (p<.001) than did those with fewer physical symptoms. Both the number and the costs of services increased with the number of physical symptoms presented at intake. Patients with major depressive disorder were as likely as patients with schizophrenia or bipolar disorder to report having three or more physical symptoms.

Conclusions:

Within a mental health community-based population, most incoming clients with serious mental illness reported three or more physical symptoms. The number of reported physical symptoms was a significant predictor of mental health service use and cost over the episode of care, even after analyses controlled for confounders such as gender, age, and diagnosis. (Psychiatric Services 62:1146–1151, 2011)

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Table 1 Number of physical symptoms among 682 community mental health center patients, by gender, language, and diagnosis
Table 2 Covariates of number of physical symptoms among 682 community mental health center patients
Table 3 Service use and characteristics as a function of number of physical symptoms of community mental health center patients

Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Cover: Carmel, by John O'Shea, circa 1927. Oil on canvas, 28 × 32¼ inches. Crocker Art Museum, Melza and Ted Barr Collection. 2008.107.
Psychiatric Services
Pages: 1146 - 1151
PubMed: 21969640

History

Published online: 1 October 2011
Published in print: October 2011

Authors

Details

Shula Minsky, Ed.D. [email protected]
Dr. Minsky and Dr. Gara are affiliated with the Department of Quality Improvement, University Behavioral HealthCare, 151 Centennial Ave., Piscataway, NJ 08854 (e-mail: [email protected]). They are also with the Department of Psychiatry at University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Rebecca S. Etz, Ph.D.
Dr. Etz is with the Department of Family Medicine and Community Health and Dr. Escobar is with the Department of Psychiatry at UMDNJ-Robert Wood Johnson Medical School.
Michael Gara, Ph.D. [email protected]
Dr. Minsky and Dr. Gara are affiliated with the Department of Quality Improvement, University Behavioral HealthCare, 151 Centennial Ave., Piscataway, NJ 08854 (e-mail: [email protected]). They are also with the Department of Psychiatry at University of Medicine and Dentistry of New Jersey (UMDNJ)-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Javier I. Escobar, M.D.
Dr. Etz is with the Department of Family Medicine and Community Health and Dr. Escobar is with the Department of Psychiatry at UMDNJ-Robert Wood Johnson Medical School.

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