Physical examination performed by psychiatrists

Area of Science:

• Psychiatry
• Internal Medicine
• Medical Education

Background:

• Physical examinations are crucial for psychiatric patients due to high rates of co-occurring physical illnesses.
• Psychiatric trainees are responsible for initial patient assessments, including physical exams.

Purpose of the Study:

• To evaluate the thoroughness of physical examinations conducted by psychiatric trainees on newly admitted patients.
• To measure the time elapsed before psychiatric inpatients undergo physical examinations.

Main Methods:

• Prospective case note review of 60 consecutive admissions to acute psychiatric wards.
• Data collected included patient demographics, physical examination details, and routine blood investigations.

Main Results:

• A significant delay in physical examination occurred in 28.8% of patients, averaging 61.8 hours post-admission.
• The comprehensiveness of physical examinations was variable, with only 57.6% of patients receiving a full central nervous system (CNS) examination.
• The CNS was documented as 'grossly intact' in only 10.2% of cases.

Conclusions:

• Current practices indicate that psychiatric patients are not consistently receiving comprehensive physical examinations.
• Delays and incomplete assessments, particularly of the CNS, suggest potential missed opportunities for early intervention in physical health issues.
• Further improvements in medical education and clinical practice are needed to ensure adequate physical health monitoring in psychiatric inpatients.