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Physical illness presenting as psychiatric disease.

R C Hall, M K Popkin, R A Devaul

    Archives of General Psychiatry
    |November 1, 1978
    PubMed
    Summary

    Medical disorders cause psychiatric symptoms in 9.1% of patients, often presenting as depression or confusion. Many patients had undiagnosed medical conditions, highlighting the need for thorough medical evaluations in psychiatric care.

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    Area of Science:

    • Psychiatry
    • Internal Medicine
    • Medical Diagnostics

    Background:

    • Psychiatric symptoms can stem from underlying medical conditions.
    • A significant portion of psychiatric patients may have undiagnosed medical illnesses.
    • Comprehensive medical evaluation is crucial for accurate psychiatric diagnosis.

    Purpose of the Study:

    • To determine the incidence of medical disorders presenting as psychiatric symptoms.
    • To identify the types of medical illnesses most commonly associated with psychiatric presentations.
    • To emphasize the importance of medical assessment in psychiatric outpatient settings.

    Main Methods:

    • Study of 658 consecutive psychiatric outpatients.
    • Inclusion of thorough medical and biochemical evaluations.

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  • Analysis of presenting psychiatric symptoms and underlying medical diagnoses.

    • Main Results:

    • 9.1% of psychiatric outpatients had medical disorders causing their symptoms.
    • Common presentations included depression, confusion, anxiety, and speech/memory deficits.
    • Infectious, pulmonary, thyroid, diabetic, hematopoietic, hepatic, and CNS diseases were frequent causes.
    • 46% of these patients had previously unknown medical illnesses.

    Conclusions:

    • Medical disorders are a significant cause of psychiatric symptoms.
    • Visual hallucinations warrant investigation for medical etiology.
    • Routine medical evaluation is essential for psychiatric patients to uncover undiagnosed conditions.