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Which Neurotic Patients Do Psychiatrists Treat?

Published online by Cambridge University Press:  02 January 2018

John M. Eagles*
Affiliation:
Royal Cornhill Hospital, Aberdeen and University of Aberdeen
David A. Alexander
Affiliation:
Course for the Diploma in Psychotherapy, Medical School, University of Aberdeen
*
Ross Clinic, Royal Cornhill Hospital, Cornhill Road, Aberdeen

Abstract

Of 336 newly referred neurotic patients, 80 were not offered continuing psychiatric treatment. The factors associated with patients' not being offered continuing treatment were: short duration of illness; history of alcohol abuse and/or deliberate self-harm; age over 50 years; being widowed; and living more than 20 miles from the main hospital complex. The implications of these findings are discussed.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

Alexander, D. A. & Dunnett, N. G. M. (1975) Duration of stay and outcome for first admissions to the psychiatric service of the North-eastern region of Scotland. Health Bulletin, 33, 1823.Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorder (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Anonymous (1982) Goodbye neurosis? The Lancet, ii, 2930.Google Scholar
Bachrach, L. L. (1983) Psychiatric services in rural areas: a sociobiological overview. Hospital and Community Psychiatry, 34, 215226.Google Scholar
Berry, B. & Davis, A. E. (1978) Community mental health ideology: a problematic model for rural areas. American Journal of Orthopsychiatry, 48, 673679.Google Scholar
Brown, G. W. & Harris, T. (1978) Social origins of depression. London: Tavistock Publications.Google Scholar
Brown, G. W. & Prudo, R. (1981) Psychiatric disorder in a rural and an urban population: I. Aetiology of depression. Psychological Medicine, 11, 581599.Google Scholar
Brown, J. S. & Kosterlitz, N. (1964) Selection and treatment of psychiatric out-patients. Archives of General Psychiatry, 11, 425438.Google Scholar
Chick, J., Lloyd, G. & Crombie, E. (1985) Counselling problem drinkers in medical wards: a controlled study. British Medical Journal, 290, 965967.CrossRefGoogle ScholarPubMed
Clayton, P., Halikas, J. & Maurice, W. (1972) The depression of widowhood. British Journal of Psychiatry, 120, 7177.CrossRefGoogle ScholarPubMed
Cooper, B., Fry, J. & Kalton, G. (1969) A longitudinal study of psychiatric morbidity in a general practice population. British Journal of Preventive and Social Medicine, 23, 210217.Google Scholar
Deitch, R. (1984) Proposals for improvement of NHS care in country areas. The Lancet, i, 13071308.CrossRefGoogle Scholar
Duxbury, R. A. (1983) Willingness of graduate social work students to treat alcoholics; a replication study. Journal of Studies on Alcohol, 44, 748753.Google Scholar
Fisher, J. C., Mason, R. L., Keeley, K. A. & Fisher, J. V. (1975) Physicians and the alcoholic; the effect of medical training on attitudes toward alcoholics. Journal of Studies on Alcohol, 36, 949955.CrossRefGoogle ScholarPubMed
Gelder, M. G. (1986) Neurosis: another tough old word. British Medical Journal, 292, 972973.Google Scholar
Gordon, D., Alexander, D. A. & Dietzan, J. (1979) The psychiatric patient: a voice to be heard. British Journal of Psychiatry, 135, 115121.Google Scholar
Hagnell, O. (1966) A Prospective Study of the Incidence of Mental Disorder. Stockholm: Scandinavian University Books.Google Scholar
Hagnell, O. (1970) The incidence and duration of mental illness in a total population. In Psychiatric Epidemiology (eds Hare, E. H. & Wing, J. K.). London: Oxford University Press.Google Scholar
Harvey-Smith, E. A. & Cooper, B. (1970) Patterns of neurotic illness in the community. Journal of Royal College of General Practitioners, 19, 132139.Google Scholar
Hawton, K. & Catalan, J. (1981) Psychiatric management of attempted suicide patients. British Journal of Hospital Medicine, 25, 365372.Google ScholarPubMed
Johnson, D. A. W. (1973a) An analysis of out-patient services. British Journal of Psychiatry, 122, 301306.Google Scholar
Johnson, D. A. W. (1973b) A further study of psychiatric out-patient services in Manchester: an operational study of general practitioner and patient expectation. British Journal of Psychiatry, 123, 185191.CrossRefGoogle ScholarPubMed
Kaeser, A. C. & Cooper, B. (1971) The psychiatric patient, the general practitioner and the out-patient clinic: an operational study and a review. Psychological Medicine, 1, 312325.CrossRefGoogle Scholar
Kessel, N., Hassall, C., Blair, R., Gilroy, J. M., Pilkington, F. & Weeks, K. F. (1965) Psychiatric out-patients in Plymouth – an area service analysed. British Journal of Psychiatry, 111, 1017.Google Scholar
Kessel, N., Hassall, C., Blair, R., Gilroy, J. M., Pilkington, F. & Weeks, K. F. (1971) Evaluation of the functioning of the Plymouth Nuffield Clinic. British Journal of Psychiatry, 118, 305312.Google Scholar
Kessel, N., & Shepherd, M. (1962) Neurosis in hospital and general practice. Journal of Mental Science, 108, 159166.Google Scholar
Kreitman, N. (1983) Suicide and parasuicide. In Companion to Psychiatric Studies (eds Kendell, R. E. & Zealley, A. K.). Edinburgh: Churchill Livingstone.Google Scholar
Lavik, N. J. (1982) Marital status in psychiatric patients. Acta Psychiatrica Scandinavica, 65, 1528.CrossRefGoogle ScholarPubMed
Leighton, D. C., Harding, J. S., Macklin, B., Hughes, C. C. & Leighton, A. H. (1963) Psychiatric findings in the Stirling County Study. American Journal of Psychiatry, 119, 10211026.Google Scholar
Lewis, C. E., Robins, L. & Rice, J. (1985) Association of alcoholism with antisocial personality in urban men. Journal of Nervous and Mental Diseases, 173, 166174.Google Scholar
Malan, D. H., Heath, E. S., Bacal, H. A. & Balfour, F. H. G. (1975) Psychodynamic changes in untreated neurotic patients: II Apparently genuine improvements. Archives of General Psychiatry, 32, 110126.Google Scholar
McAvoy, B. M. (1986) Death after bereavement. British Medical Journal, 293, 835836.Google Scholar
McCance, C. & McCance, P. F. (1969) Alcoholism in north-east Scotland: its treatment and outcome. British Journal of Psychiatry, 115, 189198.Google Scholar
McLennan, A. T., Luborsky, L., Woody, G. E., O'Brien, C. P. & Druley, K. A. (1983) Predicting response to alcohol and drug abuse treatments. Role of psychiatric severity. Archives of General Psychiatry, 40, 620625.Google Scholar
Morgan, H. G., Barton, J., Pottle, S., Pocock, H. & Burne-Cox, C. J. (1976) Deliberate self-harm: a follow-up of 279 patients. British Journal of Psychiatry, 128, 361368.Google Scholar
Mullan, M. J., Gurling, H. M. D., Oppenheim, B. E. & Murray, R. M. (1986) The relationship between alcoholism and neurosis: evidence from a twin study. British Journal of Psychiatry, 148, 435441.Google Scholar
Mullaney, J. A. & Trippett, C. J. (1979) Alcohol dependence and phobias: clinical description and relevance. British Journal of Psychiatry, 135, 565573.CrossRefGoogle ScholarPubMed
Niskanen, P., Koskinen, T., Lepola, U. & Venalainen, E. (1975) A study of attempted suicide in urban versus rural areas, with a follow-up. Acta Psychiatrica Scandinavica, 52, 283291.Google Scholar
O'Brien, G., Holton, A. R., Hurren, K., Watt, L. & Hassanyeh, F. (1986) Deliberate self-harm and predictors of out-patient attendance. British Journal of Psychiatry, 150, 246247.Google Scholar
Parkes, C. M. (1985) Bereavement. British Journal of Psychiatry, 146, 1117.Google Scholar
Potamianos, G., Gorman, D. M., Peters, T. J. (1985) Attitudes and treatment expectancies of patient and general hospital staff in relation to alcoholism. British Journal of Medical Psychology, 58, 6366.Google Scholar
Prudo, R., Brown, G. W., Harris, T. & Dowland, J. (1981) Psychiatric disorder in a rural and an urban population: 2. Sensitivity to loss. Psychological Medicine, 11, 601616.Google Scholar
Prudo, R., Harris, T. & Brown, G. W. (1984) Psychiatric disorder in a rural and an urban population: 3. Social integration and the morphology of affective disorder. Psychological Medicine, 14, 327345.CrossRefGoogle Scholar
Robertson, N. C. (1974) The relationship between marital status and the risk of psychiatric referral. British Journal of Psychiatry, 124, 191202.Google Scholar
Samarasinghe, D. S., Tilley, S. & Marks, I. M. (1984) Alcohol and sedative drug use in neurotic out-patients. British Journal of Psychiatry, 145, 4548.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Katton, G. (1981) Psychiatric Illness in General Practice (2nd edn). Oxford: Oxford University Press.Google Scholar
Sims, A. C. P. (1975) Factors predictive of outcome in neurosis. British Journal of Psychiatry, 127, 5462.Google Scholar
Sims, A. C. P. (1983) Neurosis in Society. London: McMillan Press.Google Scholar
Sims, A. C. P. (1985) Neurotic illness: conserving a threatened concept. British Journal of Clinical Pharmacology, 19, (suppl.), 915.Google Scholar
Stein, Z. & Susser, M. (1969) Widowhood and mental illness. British Journal of Preventive and Social Medicine, 23, 106110.Google Scholar
Surtees, P. G., Sashidharan, S. P. & Dean, C. (1986) Affective disorder amongst women in the general population: a longitudinal study. British Journal of Psychiatry, 148, 176186.Google Scholar
Tennant, C., Bebbington, P. & Hurry, J. (1981) The short-term outcome of neurotic disorders in the community: the relation of remission to clinical factors and to ‘neutralising’ life events. British Journal of Psychiatry, 139, 213220.Google Scholar
Tyrer, P., Casey, P. & Gall, J. (1983) Relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404408.Google Scholar
Wechsler, H. & Rohman, M. (1982) Future caregivers' views on alcoholism treatment: a poor prognosis. Journal of Studies on Alcohol, 43, 939955.Google Scholar
Weissman, M. M. & Myers, J. K. (1978) Rates and risks of depressive symptoms in a United States urban community. Acta Psychiatrica Scandinavica, 57, 219231.Google Scholar
Willems, P. J. A., Letemendia, F. J. J. & Arroyave, F. (1973) A two-year follow up study comparing short with long-stay in-patient treatment of alcoholics. British Journal of Psychiatry, 122, 637648.Google Scholar
Wilson, G. T., Abrams, D. B. & Lipscomb, T. R. (1980) Effect of intoxication levels and drinking pattern on social anxiety in men. Journal of Studies on Alcohol, 41, 250264.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
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