The aim of the present study was to examine whether psychiatric morbidity can influence the type of illness behaviour of neurological inpatients.

For this purpose, we compared neurological inpatients with and without psychiatric disorders (DSM-IIIR criteria) for the seven scales of Illness Behaviour Questionnaire (IBQ) and searched for possible differences between the two patient subgroups.

Of the 105 neurological inpatients who participated in the study, 54 (51.4%) were diagnosed as having some type of psychiatric disorder. These patients scored significantly higher than patients without psychiatric morbidity in the scale of Irritability. A suggestive trend for higher scores in the scales of Hypochondriasis, Disease Conviction, and Affective Disturbance, and significantly lower score in the scale of Denial, in patients with psychiatric morbidity, were also found.

The present study has shown that neurological inpatients with psychiatric morbidity tend to develop more intense illness behaviour than those without. The effect of psychiatric morbidity on certain components of illness behaviour in neurological patients can be taken into account when therapeutic strategies are planned.

The classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior, irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill.

A cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate.

Three clusters were identified: non-specific psychological distress, irritability and affective disturbances with somatization.

Two-step cluster analysis revealed clusters that were found to occur across clinical settings. The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, illness behavior and subclinical distress encompassed by the DCPR.

Primary care providers and researchers wishing to estimate study recruitment rates need estimates of illness frequency in primary care. Previous studies of children’s symptoms have found that presentations are most common for the symptoms: cough, fever, earache, rash, diarrhoea and vomiting. Since 2000, primary care provision in the United Kingdom has changed with the introduction of Walk-in-Centres (WICs) and new Out of Hours (OoHs) providers.

To describe the type and frequency of parent-reported presenting symptoms at a range of primary care sites between 2005 and 2007.

Parent-reported presenting symptoms, recorded in their own words, were extracted from data collected from all children aged six months to six years during recruitment to a randomised controlled trial. Presenting symptoms were coded and presented as frequency per 100 ‘consulting sessions’ by type of primary care site.

Results were evaluated from 2491 episodes of illness at 35 sites. When grouped by primary care site, respiratory symptoms were the most common at OoHs centres, the WIC and general practitioner (GP) surgeries. Trauma symptoms were common in the Emergency Department, but unexpectedly, diarrhoea and vomiting were more common in the Emergency Department and skin presenting symptoms more common at the WIC than at GP sites.

We report the relative frequency of acute symptoms by type of primary care provider. These data may be useful to those planning recruitment to primary care paediatric studies and policy makers for planning primary care service provision.