Psychiatric morbidity among medical out-patients in Kuwait: evaluation of a somatic inventory to identify the psychaitric from the non-psychatric patients

The aim of this study was to evaluate the Bradford Somatic Inventory [BSI], a 21-item questionnaire, to identify psychiatric patients attending a general hospital medical clinic in Kuwait. The sample consisted of 100 new general hospital medical out-patient clinic attendees. All patients were administered the BSI, and their psychiatric status was established by administration of the Present State Examination. All the patients who met the criteria of the International Classification of Diseases, 10th revision [ICD-10], were grouped as 'psychiatric' while the remaining subjects were regarded as 'non-psychiatric' patients. The frequency of endorsement and the total BSI scores were computed to determine sensitivity, specificity and positive predictive values of the BSI. Fifty-one of the psychiatric patients met the ICD-10 diagnostic criteria. The psychiatric group reported a significantly higher number of BSI symptoms and had a significantly higher mean BSI total score than the non-psychiatric patients. Using a cut-off score of 13/14, the BSI-21 yielded a sensitivity rate of 72.5% and a specificity rate of 73.47%. Evaluation of a shorter version, the BSI-15, comprising the most frequently endorsed items by the psychiatric patients, revealed similar results. Conclusions: The findings suggest that the BSI-21 is a potentially useful screening instrument to identify psychiatric patients attending general medical out-patient clinics. The shorter version, BSI-15, is easier to administer and equally effective in discriminating the psychiatric from the non-psychiatric group of medical patients

Psychiatric morbidity among the general hospital medical patients in Kuwait: characteristics of psychiatric patients

A considerable number of medical out-patients seen in a general hospital are known to suffer from psychiatric rather than/in addition to the physical disorder. Moreover, a substantial number of such patients, passing undetected by the physicians, end up being physically examined and investigated, at times far too extensively. This study was aimed at determining the prevalence of such patients in a general hospital in Kuwait. The sample consisted of 100 new medical out-patient clinic attenders. Each patient was administered a semi-structured interview. The items of the interview were derived from the Present State Examination, and the 10th revision of the International Classification of Diseases was used to assign psychiatric diagnoses. Fifty-one out of the 100 patients suffered from psychiatric disorders. In only 5 cases was the disorder recognized. Psychiatric disorders were commoner in females and were not related to the nature of the physical disorders. Conclusions: Inclusion of some screening questions about mood disorders in the standard medical interview may help detect some of the psychiatric patients presenting in the general medical out-patient clinics. In addition, periodic clinical meetings between psychiatrists and physicians may enhance physicians' awareness of the potential psychiatric morbidity amongst the medical out-patients