Improvements in somatic complaints among individuals with serious mental illness receiving treatment in a psychiatric hospital

Alok Madan, Joshua Clapp, Patricia Osborne, Cory Walker, B. Christopher Frueh, Jon Allen, John Oldham, James Chris Fowler

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: Individuals with serious mental illness (SMI) experience significant comorbid somatic complaints. Little is known about response to integrated inpatient care that addresses psychiatric and general medical needs among individuals with SMI. Methods: Latent growth curve analyses were used to model somatic symptom trajectories across adult inpatients with SMI (n = 989). The Patient Health Questionnaire-15 (PHQ-15) was administered at admission, every 14 days, and at discharge. Results: Patients evidenced substantial reduction in somatization from admission (mean [standard deviation] = 9.0 [5.2]) to discharge (mean [standard deviation] = 5.2 [4.4]), with large effects (d = 0.83, 95% confidence interval = 0.76-0.90). Results indicate nonlinear improvement in somatic symptoms for 8 weeks of treatment, with greatest symptom reduction occurring during the first weeks of treatment with continued, albeit slowed, improvement until discharge. Initial PHQ-15 scores were lower among men and those who reported regular exercise in the 30 days preceding this hospitalization. In addition, presence of an anxiety disorder or personality disorder at admission; history of trauma, a gastrointestinal disorder, or major medical illness (within the past 3 months); and significant sleep disturbance independently contribute to higher PHQ-15 scores at admission. A substance use disorder and sleep disturbance were associated with greater immediate symptom reduction. Conclusions: Somatic complaints can be managed in the context of inpatient psychiatric care integrated with 24-hour nursing and internal medicine specialists. Addressing psychiatric impairments, improving sleep, and ensuring abstinence from drugs and alcohol are associated with significant improvement in somatic complaints.

Original languageEnglish (US)
Pages (from-to)271-280
Number of pages10
JournalPsychosomatic Medicine
Volume78
Issue number3
DOIs
StatePublished - Jan 1 2016

Keywords

  • Clinical outcomes
  • Hospitalized patients
  • Inpatient treatment
  • Serious mental illness
  • Somatic complaints

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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