Neurovegetative dystonia--psychiatric evaluation of 40 patients diagnosed by general physicians in Brazil.
J Psychosom Res
; 43(5): 489-95, 1997 Nov.
Article
em En
| MEDLINE
| ID: mdl-9394265
ABSTRACT
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
/
Transtornos Psicofisiológicos
/
Transtornos Somatoformes
/
Doenças do Sistema Nervoso Autônomo
/
Distonia
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Qualitative_research
Limite:
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
J Psychosom Res
Ano de publicação:
1997
Tipo de documento:
Article
País de afiliação:
Brasil