Thus, there was no evidence of systematic "diagnostic overshadowing," the phenomenon by which physical complaints are attributed to underlying psychiatric disease.
A clinical diagnosis of influenza or ILI was noted in only 7% (1 of 14) and 38% (1 of 2.6) of the estimated excess visits with respiratory complaints that were attributed to seasonal and H1N1/2009 pandemic influenza, respectively (Table 1).
In all cases, the chief complaint and the metabolic alterations were attributed to DKA and all alternative diagnoses were ruled out.
The problems were attributed mainly to complaints in two categories, one of which was related to audio, entertainment and navigation systems.
On further discussion it emerged that these issues were attributed to other health complaints, including severe allergies that were unrelated to glaucoma.
It is likely that the high frequency of somatic complaints can be attributed to the physical consequences of morbid obesity, e.g. musculoskeletal pain or shortness of breath.
In addition, the psychiatric illness may be unrecognized and untreated, especially in elderly patients whose physical complaints may be attributed to a tendency to ruminate or to worry excessively, or be incorrectly attributed to the consequences of aging.
Patients who met RDC critera for insomnia and had a co-morbid condition, but where the insomnia was not the primary complaint and was attributed exclusively to the other disorder (be it sleep, medical, or psychiatric) were excluded from this study.
Other complaints couldn't be attributed to confusion.
Veterans who sustained mTBI without persisting problems would be less likely to seek treatment from the CVAMC, and veterans who had complaints that might be attributed to a prior mTBI might misremember that an episode of trauma included mTBI when there was no TBI.
