General Hospital Psychiatry (GEN HOSP PSYCHIAT)

Publisher: Elsevier

Journal description

General Hospital Psychiatry explores the linkages and interfaces among psychiatry, medicine and primary care. The Journal emphasizes a biopsychosocial approach to illness and health, and provides a forum for communication among professionals with clinical, academic, and research interests in psychiatry's essential function in "the mainstream of medicine." Building upon those liaison consultation and psychiatric services which have burgeoned in the general hospital setting, the Journal expands beyond this base to encourage new contributions to the understanding and treatment of illness - in inpatient, ambulatory, and community settings. Studies of multisystem relationships of life stresses, physical experience, psychosocial factors, interpersonal and intrapsychic reactions, family structure, ecological change, and institutional forces are especially relevant to the Journal's objectives. General Hospital Psychiatry publishes original articles on biopsychosocial approaches to medicine; liaison-consultation psychiatry; the relationship of psychiatric services to general medical systems; and new directions in medical education which stress psychiatry's role in primary care, family practice, and continuing education. It also features Brief Communications, News and Notes, Book Reviews, and Medical Psychiatric Rounds, of interest to physicians and other professionals and students in this field.

Current impact factor: 2.61

Impact Factor Rankings

2016 Impact Factor Available summer 2017
2014 / 2015 Impact Factor 2.606
2013 Impact Factor 2.898
2012 Impact Factor 2.977
2011 Impact Factor 2.744
2010 Impact Factor 2.777
2009 Impact Factor 2.669
2008 Impact Factor 2.229
2007 Impact Factor 2.117
2006 Impact Factor 2.5
2005 Impact Factor 2.248
2004 Impact Factor 1.706
2003 Impact Factor 1.703
2002 Impact Factor 1.542
2001 Impact Factor 2.065
2000 Impact Factor 1.512
1999 Impact Factor 1.4
1998 Impact Factor 1.144
1997 Impact Factor 1.298
1996 Impact Factor 1.337
1995 Impact Factor 1.028
1994 Impact Factor 1.116
1993 Impact Factor 0.92
1992 Impact Factor 0.739

Impact factor over time

Impact factor

Additional details

5-year impact 3.12
Cited half-life 7.10
Immediacy index 0.30
Eigenfactor 0.01
Article influence 1.10
Website General Hospital Psychiatry website
Other titles General hospital psychiatry (Online)
ISSN 0163-8343
OCLC 38884908
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Authors pre-print on any website, including arXiv and RePEC
    • Author's post-print on author's personal website immediately
    • Author's post-print on open access repository after an embargo period of between 12 months and 48 months
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months
    • Author's post-print may be used to update arXiv and RepEC
    • Publisher's version/PDF cannot be used
    • Must link to publisher version with DOI
    • Author's post-print must be released with a Creative Commons Attribution Non-Commercial No Derivatives License
    • Publisher last reviewed on 03/06/2015
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: The Patient Health Questionnaire (PHQ-9) is a widely used screening tool for major depressive disorder (MDD), although there is debate surrounding its diagnostic properties. For the PHQ-9, we aimed to: 1. Establish the diagnostic performance at the standard cutoff point (10). 2. Compare the diagnostic performance at the standard cutoff point in different clinical settings. 3. Assess whether there is selective reporting of cutoff points other than 10. We searched three databases - Embase, MEDLINE and PSYCHInfo - and performed a reverse citation search in Web of Science. We selected for inclusion studies of any design that assessed the PHQ-9 in adult populations against recognized gold-standard instruments for the diagnosis of either Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria for major depression. Included studies had to report sufficient information to calculate 2*2 contingency tables. Data extraction and synthesis were performed independently by two researchers. For the included studies, we calculated pooled sensitivity, pooled specificity, positive likelihood, negative likelihood ratio and diagnostic odds ratio for cutoff points 7 to 15. Thirty-six studies (21,292 patients) met inclusion criteria. Pooled sensitivity for cutoff point 10 was 0.78 [95% confidence interval (CI), 0.70-0.84], and pooled specificity was 0.87 (95% CI, 0.84-0.90). At this cutoff, the PHQ-9 is a better screener in primary care than secondary care settings. No conclusions could be drawn at cutoff points other than 10 due to selective reporting of data. For MDD, the PHQ-9 has acceptable diagnostic properties at cutoff point 10 in different settings. We recommend that future studies report the full range of cutoff points to allow exploration of optimal cutoff points in different settings. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Jun 2015 · General Hospital Psychiatry
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    ABSTRACT: Delineating clinically meaningful subgroups within heterogeneous depressed populations is a major challenge. As outlined in the Research Domain Criteria Strategy, biomarkers may help to empirically classify such patients. Following this basic strategy, the current pilot study examined whether the cortisol awakening response (CAR) following admission to hospital predicts treatment response in heterogeneous depressed patients completing a 4-week alternate milieu inpatient program. The Alternate Inpatient Milieu program at the Centre for Addiction and Mental Health is composed of both individual-based and group-based programming designed to promote a recovery-oriented, collaborative treatment environment. The current sample consisted of 25 consecutive patients with various forms of complex/chronic depression who completed the full program. Saliva samples were collected at 0, 30 and 60 min after awakening on 2 consecutive days following admission. Linear regressions controlling for baseline depression scores were used to assess whether the CAR AUCg (area under the curve ground) and/or AUCi (area under the curve increase) at admission predicted the change in depression scores from admission to discharge based on the Quick Inventory of Depressive Symptoms scale. The CAR AUCi, but not the CAR AUCg, at admission significantly predicted treatment response over the 4-week hospital stay. In these naturalistic patients with major depressive disorder, high CAR reactivity as assessed using the AUCi was associated with a better treatment response (t=2.20; df=2,24; P=.039). The CAR was easy to implement and well accepted by patients and staff. This pilot study suggests that CAR reactivity at admission may help to identify a subgroup of depressed patients most likely to respond clinically to a 4-week alternate milieu inpatient program. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Jun 2015 · General Hospital Psychiatry
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    ABSTRACT: To explore the reasons for worse cancer survival in people with experience of mental illness, including differences by cancer type and psychiatric diagnosis. New Zealand breast and colorectal cancer registrations (2006-2010) were linked to psychiatric hospitalization records for adults (18-64 years). Cancer-specific survival was compared for recent psychiatric service users and nonusers using Cox regression. The contributions of deprivation, comorbidity and stage at diagnosis were assessed for those with schizophrenia or bipolar affective disorder (Group A) and others using mental health services (Group B). Of 8762 and 4022 people with breast and colorectal cancer respectively, 440 (breast) and 190 (colorectal) had recent contact with psychiatric services. After adjusting for confounding, risk of death from breast cancer was increased for Group A [Hazard Ratio (HR) 2.55 (95% confidence interval 1.49-4.35)] and B [HR 1.62 (1.09-2.39)] and from colorectal cancer for Group A [HR 2.92 (1.75-4.87)]. Later stage at diagnosis contributed to survival differences for Group A, and comorbidity contributed for both groups. Fully adjusted HR estimates were breast: Group A 1.65 (0.96-2.84), B 1.41 (0.95-2.09); colorectal: Group A 1.89 (1.12-3.17), B 1.25 (0.89-1.75)]. The high burden of physical disease and delayed cancer diagnosis in those with psychotic disorders contributes to worse cancer survival in New Zealand psychiatric service users. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Jun 2015 · General Hospital Psychiatry
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    ABSTRACT: This prospective study investigates the relationships between depressive symptoms, psychiatric medication use, and their interaction on risk of developing type 2 diabetes. Data come from the 1998-2010 waves of the Health and Retirement Study, a US nationally representative cohort of adults aged 51 years and older. Analysis is restricted to participants <65 years old who did not have diabetes in 1998 (N=8704). Depressive symptoms were assessed using the 8-item Center for Epidemiologic Studies-Depression Scale. Risk of diabetes over the 12-year follow-up period was assessed using Cox proportional hazard models with time-varying covariates. After adjusting for covariates, both depressive symptoms [hazard ratio (HR): 1.06, 95% confidence interval (CI): 1.02-1.09] and psychiatric medication use (HR: 1.57, 95% CI: 1.25-1.96) were associated with development of diabetes. The interaction between depressive symptoms and medication use was significant (beta=-0.240, P=.049), indicating that the association between elevated depressive symptoms and diabetes was higher among respondents not taking medications. The associations between depressive symptoms and medication use were also attenuated by increasing body mass index. Findings highlight the complex relationship between depressive symptoms and psychiatric medications on diabetes risk and the need for a nuanced understanding of these factors. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · May 2015 · General Hospital Psychiatry
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    ABSTRACT: The objective was to compare a brief interdisciplinary psychotherapeutic intervention to standard care as treatments for patients recently diagnosed with severe motor conversion disorder or nonepileptic attacks. This randomized controlled trial of 23 consecutive patients compared (a) an interdisciplinary psychotherapeutic intervention group receiving four to six sessions by a consultation liaison psychiatrist, the first and last sessions adding a neurological consultation and a joint psychiatric and neurological consultation, and (b) a standard care group. After intervention, patients were assessed at 2, 6 and 12 months with the Somatoform Dissociation Questionnaire (SDQ-20), Clinical Global Impression scale, Rankin scale, use of medical care, global mental health [Montgomery and Asberg Depression Rating Scale, Beck Depression Inventory, mental health component of Short Form (SF)-36] and quality of life (SF-36). We calculated linear mixed models. Our intervention brought a statistically significant improvement of physical symptoms [as measured by the SDQ-20 (P<.02) and the Clinical Global Impression scale (P=.02)] and psychological symptoms [better scores on the mental health component of the SF-36 (P<.05) and on the Beck Depression Inventory (P<.05)] and a reduction in new hospital stays after intervention (P<.05). A brief psychotherapeutic intervention taking advantage of a close collaboration with neurology consultants in the setting of consultation liaison psychiatry appears effective. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · May 2015 · General Hospital Psychiatry
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    ABSTRACT: Our objective was to validate a scale for the evaluation of attitudes of physicians toward integrating consultation-liaison psychiatric services and then apply it among the nonpsychiatrist attending physicians of four major general hospitals in Tehran. The eight-item Doctors' Attitudes toward Collaborative Care for Mental Health (DACC-MH) Scale was translated to Persian and back-translated to English by nonphysician translators and was presented for expert opinion to four psychiatrists for assessment of face validity. The validated questionnaires were presented to nonpsychiatrist attending physicians of four major general university-affiliated hospitals with consultant-liaison psychiatric services in Tehran, and the returned questionnaires were analyzed using the 21st version of SPSS software. The score for each physician was generated by counting positive responses of the eight items questioned. Of the 300 questionnaires presented, 193 (64.3%) were returned. The mean score of the respondents was 6.62 (±1.33) for the Farsi version of the DACC-MH which was significantly higher than the assumed mean score of 4, according to the independent-sample t test (P<.001). The mean score of the respondents for the first four items of the DACC-MH was 3.49, which was significantly higher than that of the second four items of the scale which was 3.13 (P<.01) according to the Wilcoxon test. The respondents have an above-average positive attitude toward integrating consultation-liaison psychiatric services for the management of psychiatric disorders among inpatients. They had a more positive attitude toward requesting psychiatric consultations than managing the patients' psychiatric disorders themselves. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · May 2015 · General Hospital Psychiatry
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    ABSTRACT: To summarize and critically review the existing literature on the prevalence of posttraumatic stress disorder (PTSD) following organ transplantation, risk factors for posttransplantation PTSD and the relationship of posttransplant PTSD to other clinical outcomes including health-related quality of life (HRQOL) and mortality. We conducted a systematic literature review using PubMed, CINAHL Plus, the Cochrane Library and PsycInfo and a search of the online contents of 18 journals. Twenty-three studies were included. Posttransplant, the point prevalence of clinician-ascertained PTSD ranged from 1% to 16% (n=738), the point prevalence of questionnaire-assessed substantial PTSD symptoms ranged from 0% to 46% (n=1024) and the cumulative incidence of clinician-ascertained transplant-specific PTSD ranged from 10% to 17% (n=482). Consistent predictors of posttransplant PTSD included history of psychiatric illness prior to transplantation and poor social support posttransplantation. Posttransplant PTSD was consistently associated with worse mental HRQOL and potentially associated with worse physical HRQOL. PTSD may impact a substantial proportion of organ transplant recipients. Future studies should focus on transplant-specific PTSD and clarify potential risk factors for, and adverse outcomes related to, posttransplant PTSD. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · May 2015 · General Hospital Psychiatry
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    ABSTRACT: In primary care, screening instruments for mental health should be ultrashort to allow for routine usage. In this paper, Stochastic Curtailment is introduced as a method for constructing ultrashort screeners. In a post hoc diagnostic accuracy study using the item scores on the Patient Health Questionnaire depression module (PHQ-9) of a large sample (N=20, 685), Stochastic Curtailment was compared with two existing ultrashort versions of PHQ-9. The first was PHQ-2 (which includes the first two items of PHQ-9), and the second was a 'two-step' method (only if the PHQ-2 screened positive were all nine PHQ items administered). For PHQ-2 and two-step, both cut scores 2 and 3 were evaluated. PHQ-2 showed the lowest and Stochastic Curtailment the highest diagnostic accuracy with reference to the classifications based on the full PHQ-9. To do so, Stochastic Curtailment used 3.08 items on average (S.D.=1.98), which was slightly less than two-step (M=3.18, S.D.=2.62) under its most accurate cut score (≥2). It was concluded that Stochastic Curtailment is a promising method for constructing ultrashort screeners. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · May 2015 · General Hospital Psychiatry