This project will seek to demonstrate the cost-effectiveness of a consultation/liaison psychiatric intervention in patients with somatization disorder and in patients who somatize. This psychiatric disorder leads to severe functional disability and enormous, inappropriate health care utilization. Our group has published data which indicates that a standardized consultation/liaison intervention can be very successful in maintaining somatization disorder patient's functional health while sharply reducing their health care utilization. The proposed project is a randomized controlled treatment trial of 60 somatization disorder patients and 60 patients who somatize which are seen in primary case settings. The study will have a two year retrospective baseline phase, a two year prospective outcome phase, and a one-way cross from control to treatment status after one year. Outcome measures will be patient quality of life, functional health, satisfaction with care, direct health care costs, and indirect health care costs. The project will provide clinically applicable information concerning the management of these difficult patients, a diagnostic index for rapid diagnosis, and a comparison of patient's who somatize and patient's with somatization disorder. It will also reproduce findings demonstrating the cost-effectiveness of psychiatric treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH041587-02
Application #
3380318
Study Section
(EPSB)
Project Start
1987-04-01
Project End
1991-03-31
Budget Start
1988-04-01
Budget End
1989-03-31
Support Year
2
Fiscal Year
1988
Total Cost
Indirect Cost
Name
University of Arkansas for Medical Sciences
Department
Type
Schools of Medicine
DUNS #
City
Little Rock
State
AR
Country
United States
Zip Code
72205
Rost, K M; Akins, R N; Brown, F W et al. (1992) The comorbidity of DSM-III-R personality disorders in somatization disorder. Gen Hosp Psychiatry 14:322-6
Kashner, T M; Rost, K; Smith, G R et al. (1992) An analysis of panel data. The impact of a psychiatric consultation letter on the expenditures and outcomes of care for patients with somatization disorder. Med Care 30:811-21
Smith Jr, G R; Witt, A S; Golding, J M (1991) The relationship of function-specific mental health measures to psychiatric diagnoses. Control Clin Trials 12:180S-188S
Smith Jr, G R (1991) Effectiveness of treatment for somatoform disorder patients. Psychiatr Med 9:545-58
Golding, J M; Smith Jr, G R; Kashner, T M (1991) Does somatization disorder occur in men? Clinical characteristics of women and men with multiple unexplained somatic symptoms. Arch Gen Psychiatry 48:231-5
Smith Jr, G R; Brown, F W (1990) Screening indexes in DSM-III-R somatization disorder. Gen Hosp Psychiatry 12:148-52
Brown, F W; Golding, J M; Smith Jr, G R (1990) Psychiatric comorbidity in primary care somatization disorder. Psychosom Med 52:445-51
Brown, F W; Smith Jr, G R (1989) Birth order of patients with DSM-III-R somatization disorder. Am J Psychiatry 146:1193-6