THE PROBLEM OF COPING AS A REASON FOR PSYCHIATRIC-CONSULTATION

To examine those patients referred to psychiatry for the ''problem of coping,'' a structured clinical databased management system-MICRO-CARES-was employed to identify the frequency, demographic characteristics, psychiatric diagnoses, psychosocial interventions, use of psychopharmacology, number of follow-up visits, and discharge placement of these referrals. Consultations totaling 1,157 from July 1, 1988 through January 1, 1990 were divided into two groups and compared: ''Not coping'' (N = 456, 28.5%) and ''others'' (N = 701, 61%). Those with a ''problem in coping'' more often had no Axis I diagnosis (p = 0.001), or were described as adjustment disorders (p = 0.0001). Fewer recommendations were made for those with a coping problem, although lag time (admission date to request for consultation), number of follow-ups, and discharge placement were not significantly different between the two groups. Stepwise logistic regression analyses revealed that the aged had lesser risk for being referred with a coping problem; those who were white, had their own income, experienced greater stress prior to hospitalization (Axis IV), and had higher functioning during the last year (Axis V) were at greater risk.