[The added value of somatic screening for psychiatric outpatients]

Abstract

BACKGROUND: Somatic disorders occur more often in psychiatric patients than in the general population; some disorders are undiagnosed at the moment of referral. According to current guidelines, patients admitted to a psychiatric clinic should receive somatic screening. This recommendation, however, does not apply to outpatients. AIM: To assess the added value of screening for somatic disorders in patients newly referred to the outpatient department of a psychiatric clinic in the Netherlands. METHOD: In a pilot study, newly referred outpatients aged between 18-65 were screened on the basis of a letter of referral, a questionnaire, an interview, standard blood tests and, if deemed necessary, additional blood tests. The screening was considered to have particular benefits when the outcome influenced the patient's subsequent somatic and/or psychiatric treatment. RESULTS: One or more 'new aspects of somatic concern' were found in 62% of the study sample. Of the total of 162 found aspects, 64% were unknown at referral. In 34% of the patients the family doctor was contacted about subsequent treatment; in 2% of the patients a medical specialist was consulted and 10% was referred to a medical specialist. CONCLUSION: A standard form of somatic screening in a psychiatric outpatient unit definitely provides added value. Further research is needed in order to optimise the screening instruments and the practicality of using such instruments.