PSYCHIATRIC SYMPTOMATOLOGY IN AN OUTPATIENT NEUROLOGY CLINIC

  • 1 January 1983
    • journal article
    • research article
    • Vol. 44  (6) , 204-206
Abstract
The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive 1st-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously.

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