Adequacy of the Comprehensive Clinical Evaluation Program A Focused Assessment (1997) / Chapter Skim
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3 The Comprehensive Clinical Evaluation Program
3 The Comprehensive Clinical Evaluation Program
Pages 17-24
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From page 17... ...
. All CCEP participants are evaluated by a primary care physician at their local medical treatment facility and receive specialty consultations if these are deemed appropriate by their primary care physician.
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From page 18... ...
At regional medical centers, CCEP activities are coordinated by board-certified internal medicine specialists who also oversee program operations of the medical treatment facilities in their region. In March 1995, DoD established the Specialized Care Center at Walter Reed Army Medical Center to provide additional evaluation, treatment, and rehabilitation for patients who are suffering from chronic debilitating symptoms.
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From page 19... ...
However, 3,309 patients who received an SSID diagnosis at Phase I were not referred to Phase II. Of the 17,567 patients who did not receive a diagnosis of SSID, 1,603 were referred for a Phase II exam.
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From page 20... ...
Those perfonn~ng Phase I and Phase II examinations were encouraged to use these definitions. Of the total population seen In the CCEP, 12.4%, or 3,078, Individuals received any diagnosis of fatigue (ICD-9 780.7~.
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From page 21... ...
CFS (°/0) Difficulty concentrating 26.8 53.8 59.5 Headache 39.6 60.4 55.4 Joint pain 51.2 76.4 68.9 Memory deficit 34.6 59.7 62.2 Muscle pain 21.8 62.3 44.6 Sleep disturbance 33.6 60.7 52.7 Abdominal pain 16.4 36.2 28.4 Bleeding gums 8.5 18.6 12.2 Depression 22.1 46.9 45.9 Diarrhea 22.1 46.9 45.9 Hair loss 12.5 17.9 14.9 Rash 29.9 40.6 50.0 Dyspnea 19.2 29.9 32.4 STRESS AND PSYCHIATRIC DISORDERS Patients who are referred to Phase II are much more likely to receive a psychological diagnosis than those who are diagnosed in Phase I
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From page 22... ...
An examination of only the second diagnosis for comorbidity with a primary psychiatric diagnosis reveals that psychological disorders are the most common at 18.0%, followed by musculoskeletal disorders at 11.1%, ill-def~ned conditions at 8.2%, digestive diseases at 6.0%, neurological disorders at 4.3%, skin diseases at 3.7%, respiratory diseases at 2.9%, infectious diseases at 1.9%, and neoplasms at 0.6%.
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From page 23... ...
of Patients Mood disorders 34.0 1,461 Somatoform disorders 24.4 1,059 PTSD 14.9 640 Anxiety disorders 5.5 237 Substance abuse 3.5 152 Other diagnoses 17.5 755 Mood disorders can be broken into the following categories: Other depressive syndromes 16.0 715 Major depression 8.9 838 Dysthymia 7.4 319 Bipolar disorder 0.7 30 Other mood disorders 0.3 14 TABLE 3.6 Comorbidity of Other Diagnoses for Patients win Primary Psychiatric Diagnosis . Diagnosis Percentage No.
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