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Psychiatric disorders in internal medicine
P Gous1, C A Gagiano, D J Weich
1Department of Psychiatry, University of the Orange Free State, Bloemfontein.
Insights
A significant percentage of general hospital patients have treatable psychiatric disorders. Current psychiatric consultation rates are low, indicating a need for enhanced liaison psychiatry services in general hospitals.
Area of Science:
- Psychiatry
- General Medicine
- Hospital Services
Background:
- Many patients admitted to general medical services have undiagnosed psychiatric conditions.
- The current model of psychiatric consultation may not adequately address the needs of these patients.
Purpose of the Study:
- To evaluate the prevalence of psychiatric disorders among general medical admissions.
- To compare the rate of psychiatric disorders with the rate of psychiatric referrals.
- To advocate for improved liaison psychiatric services.
Main Methods:
- Psychiatric evaluations were conducted on all admitted patients to a specific medical firm.
- Diagnostic and Statistical Manual of Mental Disorders (DSM III) criteria were used for diagnosis.
- Comparison was made with a control group from a comparable medical firm.
Main Results:
- 33% of patients admitted to the medical firm had treatable psychiatric disorders.
- Only 3.5% of admissions to a comparable firm were referred for psychiatric consultation.
- The difference in psychiatric disorders and consultation rates was statistically significant (P < 0.05).
Conclusions:
- A substantial proportion of general hospital medical admissions suffer from treatable psychiatric disorders.
- The low rate of psychiatric referrals suggests a gap in identifying and managing these conditions.
- Comprehensive liaison psychiatric services are necessary, exceeding the scope of traditional consultation models.
Abstract:
All patients admitted to one firm of the Department of Medicine were psychiatrically evaluated in terms of Diagnostic and Statistical Manual of Mental Disorders (DSM III, 1980) criteria. Thirty-three per cent of the patients had treatable psychiatric disorders while only 3.5% of admissions to a comparable firm of the same department were referred for psychiatric consultation (P < 0.05). These data support the need for a more comprehensive liaison psychiatric service than a mere consultation service in the general hospital.