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.
