Improvements in Somatic Complaints Among Individuals With Serious Mental Illness Receiving Treatment in a Psychiatric Hospital

Bibliographic Data

ID19306170
AuthorsAlok Madan (0000-0002-1545-5206, Baylor College of Medicine, corresponding author), John D Clapp (0000-0003-2897-5363, University of Wyoming), Joshua Clapp, Patricia Osborne, Patricia J Osborne (Menninger Clinic), Cory Walker, Cory R Walker (University of Wyoming), B Christopher Frueh (0000-0002-6218-8358, Walker (United States)), James G Allen (0000-0002-5249-9355, University of Wyoming), Jon Allen (0000-0002-2722-7235), John M Oldham (0000-0001-8344-3023, Baylor College of Medicine), John Oldham, J Christopher Fowler (0000-0001-8369-1051, Menninger Clinic)
Year2016
Volume78
Issue3
Pages271-280
Publication date2016-04-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000000298
PMID26867074
OpenAlexW2337526827
LanguageEN
Citations received1
References cited71

OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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

Abstinence · Alcohol · Alcohol use disorder · Anxiety · Context (archaeology) · Mental health · Mental illness · Psychiatry · Sleep disorder · Somatization · Somatization disorder · Medicine · Psychiatric care and mental health services · Psychosomatic Disorders and Their Treatments · Schizophrenia research and treatment