Psychiatric symptomatology in an outpatient neurology clinic

J Clin Psychiatry. 1983 Jun;44(6):204-6.


The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive first-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Depressive Disorder / diagnosis
  • Depressive Disorder / drug therapy
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology
  • Middle Aged
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / psychology*
  • Neurology
  • Outpatient Clinics, Hospital*
  • Pain / diagnosis
  • Pain / drug therapy
  • Pain / psychology
  • Personality Inventory
  • Psychiatry
  • Referral and Consultation


  • Antidepressive Agents, Tricyclic