Neurovegetative dystonia - Psychiatric evaluation of 40 patients diagnosed by general physicians in Brazil

Neurovegetative dystonia - Psychiatric evaluation of 40 patients diagnosed by general physicians in Brazil

Autor Bombana, J. A. Google Scholar
Ferraz, MPT Google Scholar
Mari, J. J. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo The diagnosis of neurovegetative dystonia (NVD) is commonly made by general physicians in Brazil, but its precise meaning is unclear. Anecdotal evidence suggests that it is used to describe patients with a wide range of psychological and physical symptoms and is often used pejoratively, in a similar way to ''crocks'' in the USA. Forty patients who had been diagnosed as having NVD by general physicians working in a triage department of a general public hospital were compared with 40 non-NVD patients, matched for age and gender, from the same department. Patients were evaluated by a psychiatrist who was blind to the diagnosis that had been made. the assessment included a structured sociodemographic questionnaire, the Clinical Interview Schedule (CIS), and a routine psychiatric interview using DSM-III-R criteria. Using the CIS, the ''reported symptoms'' that most distinguished NVD patients from controls were somatic and anxiety, whereas for ''manifest abnormality'' NVD patients displayed more anxiety, histrionic behavior, hypochondriasis, and depressive thoughts. A total of 92.5% of NVD patients received diagnoses using DSM-III-R criteria compared to 37.5% of controls. the relative risk of NVD patients subsequently receiving a psychiatric disorder was 8.3 (95% CI = 2.5-43.1, p < 0.001). Although general physicians correctly identify most patients with psychiatric disorder they miss many others. Furthermore, they use an obsolete diagnostic category which has no psychiatric currency. Medical students and residents need better psychiatric training so that they can correctly identify patients in general medical settings who are suffering from mental disorders and make a diagnosis using accepted psychiatric terminology. (C) 1997 Elsevier Science Inc.
Palavra-chave neurovegetative dystonia
vegetative (autonomic) system
medically unexplained symptoms
problem patient
somatization
Idioma Inglês
Data de publicação 1997-11-01
Publicado em Journal of Psychosomatic Research. Oxford: Pergamon-Elsevier B.V., v. 43, n. 5, p. 489-495, 1997.
ISSN 0022-3999 (Sherpa/Romeo, fator de impacto)
Publicador Elsevier B.V.
Extensão 489-495
Fonte http://dx.doi.org/10.1016/S0022-3999(97)00138-4
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:A1997YC75300006
Endereço permanente http://repositorio.unifesp.br/handle/11600/25805

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