Do Most Anxious Clients See Physicians Instead of Therapists?

 

A study in the March, 2002 issue of General Hospital Psychiatry finds that 41 percent of 7,600 people who reported feelings of nausea serious enough to consult a doctor also reported suffering from anxiety. Almost a quarter of those people also reported feelings of depression.

Psychologist Nicholas Cummings, who’s long argued that the future of psychology lies in integrating services with physicians, points out that 70 percent of a general physician’s caseload consists of patients whose physical complaints include psychological dimensions such as psychogenic illness or poor treatment compliance. Physicians actually spend 50 percent of their time, Cummings says, addressing concerns that therapists are better trained to handle. These unaddressed concerns double physical healthcare costs.

The study, by Norwegian psychiatrist Tone Tangen Haug, describes how people who experience nausea—a physical complaint that’s often psychogenic—move futilely, with much discomfort and expense, through the medical system, from general practitioners to gastrointestinal specialists. Haug notes that in a previous study, subjects reporting gastrointestinal distress were more likely to experience major depression than those reporting no distress. The same held true for panic disorder (2.5 percent to 0.7 percent) and agoraphobia (10 percent to 3.6 percent).

In Haug’s study, the association between nausea and anxiety and depression is higher among patients seeing gastrointestinal specialists than among those seeing general practitioners. This suggests that as long as these psychological components are present, the nausea isn’t amenable to treatment, Haug says. She recommends that whenever patients complain about nausea, doctors should check for anxiety and depression—and that’s an assessment that therapists are better qualified to make.

* A version of this article was first published in Psychotherapy Networker magazine, adapted with permission from Psychotherapy Network, Inc.