Am J Psychiatry 1992; 149:1711-1717
Copyright © 1992 by American Psychiatric Association
Utilization of neuropsychiatric diagnostic tests for general hospital patients with mental disorders
M Olfson
Department of Psychiatry, Cornell University Medical College, New York, NY.
OBJECTIVE: The author's goal was to determine the frequency and
distribution of neuropsychiatric diagnostic tests provided to general
hospital patients with mental disorders. METHOD: Data from the 1989
National Hospital Discharge Survey were analyzed to determine the number,
proportion, and general characteristics of 11,628 discharged patients with
primary diagnoses of mental disorders who underwent computerized tomography
(CT) scanning of the head, EEG, and magnetic resonance imaging (MRI) of the
brain. RESULTS: Of the discharged patients with mental disorders, 5.1% had
received CT scans, 2.8% had received EEGs, and 0.7% had received MRI. These
rates were below the rates for patients discharged with primary diagnoses
of neurological disorders but above the rates for patients discharged with
primary diagnoses of other medical disorders. Among the patients discharged
with mental disorder diagnoses, the likelihood of receiving a CT scan or an
EEG was greater if the primary diagnosis was an organic disorder or if the
secondary diagnosis was a medical disorder. Patients over age 65 were also
more likely to have received a CT scan. Hospital size and location had a
modest influence on the likelihood of receiving a CT scan or EEG, but the
ownership of the hospital and the patient's source of payment were not
significant influences. CONCLUSIONS: Neuropsychiatric diagnostic testing is
selectively utilized in the routine treatment of general hospital
psychiatric inpatients. Clinical variables rather than institutional or
financial variables appear to be the most powerful predictors of which
patients are selected to receive these tests.
