Patients with psychiatric disorders in gynecologic practice

OBJECTIVE: The relationship between different gynecologic complaints and so matic symptoms was studied in a gynecologic population in which the prevale nce of psychiatric disorders had been established. STUDY DESIGN: The prevalence of depression and anxiety in the unselected po pulation of 1013 subjects was 27.2% and 12.1%, respectively, as assessed by the Primary Care Evaluation of Mental Disorders (PRIME-MD). The subjects' medical charts were reviewed after the PRIME-MD diagnosis was made. RESULTS: Depression and anxiety disorders were significantly more common am ong those seeking care for abdominal pain, those who made frequent and unsc heduled visits, and those who were hospitalized for acute care. All the phy sical symptoms indicated in the PPIME-MD Patient Health Questionnaire were more common among women with a psychiatric diagnosis compared with controls . CONCLUSIONS: The majority of cases of depression and anxiety in women are u ndiagnosed and untreated, and patients with these disorders often present w ith physical symptoms. Because gynecologic outpatients with abdominal pain, frequent and unscheduled visits, and admissions due to acute illness are m ore likely to have a psychiatric disorder, it is desirable that gynecologis ts recognize and treat these problems.