An International Study of the Effect of Physical Ill Health on Psychiatric Recovery in Primary Care
Bibliographic record
Abstract
Objective: The aim of this study was to determine the association between physical morbidity and recovery from psychiatric illness in primary care. Methods: A total of 1252 psychiatric cases were recruited using a 2-stage design from 5447 subjects presenting for primary care in 14 countries. Cases were assessed at the time of screening and 1 year subsequently. Information on physical, psychiatric, and social status was obtained using the Composite International Diagnostic Instrument adapted for use in primary care (CIDI-PHC) and the Groningen Social Disability Schedule (GSDS). Assessments of psychiatric morbidity were also obtained from the patients’ family practitioners. Results: Medically explained somatic symptoms were strongly related to psychiatric outcome 1 year later. Whereas just over one half of patients (614 of 1078) with 4 or less medically explained symptoms had recovered from a psychiatric disorder, the percentage recovery fell to 38% (67 of 174) in those with 5 or more medically explained symptoms. Patients with 5 or more medically explained symptoms had a 70% increase in risk of remaining a psychiatric case 1 year later after controlling for demographics, country, initial severity of psychiatric disorder, medically unexplained somatic symptoms, and social disability. Conclusion: Physical ill health is independently associated with psychologic outcome 1 year after a patient has been seen. The needs of these patients should receive greater attention. PPGHC = Psychological Problems in General Health Care; MES = medically explained symptoms; MUS = medically unexplained symptoms; GHQ-12 = 12-item General Health Questionnaire; CIDI-PHC = Composite International Diagnostic Interview–Primary Health Care; GSDS = Groningen Social Disability Schedule; FP = family physician; SPHERE = Somatic and Psychological Health Report.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".