Unrecognized physical illness prompting psychiatric admission

Area of Science:

• Medical Diagnosis
• Psychiatry
• Clinical Assessment

Background:

• Clinicians may incorrectly attribute medical conditions to psychiatric disorders.
• This study investigates factors leading to misattribution of medical symptoms in psychiatric settings.

Purpose of the Study:

• To identify factors contributing to the misattribution of medically based mental status changes to psychiatric illness.
• To compare assessment practices for patients admitted to psychiatric versus medical units.

Main Methods:

• Retrospective review of 1340 patients in a VA hospital and 613 in a public hospital psychiatric unit (2001-2007).
• Analysis focused on cases admitted due to unrecognized medical disorders, examining pre-admission assessments and mental illness history.

Main Results:

• 2.8% of reviewed patients had a medical disorder causing their symptoms.
• Patients inappropriately admitted to psychiatric units showed lower rates of medical histories, physical exams, cognitive assessments, and vital sign treatments compared to medical unit admissions.
• A history of mental illness was significantly more prevalent in psychiatric unit admissions (85.5%) than in medical unit admissions (30.9%).

Conclusions:

• Essential medical assessment procedures are underutilized for patients with mental status changes admitted to psychiatric units.
• Patients with a documented history of mental illness are more prone to have their symptoms misattributed to psychiatric causes.