Biochemical abnormalities in psychiatric outpatients

This research project was an outgrowth of the observations of the senior author over a period exceeding four decades of practice, teaching, and research as internist and psychiatrist, with primary emphasis on relationships between psyche and soma. Patients at the Outpatient Psychiatric Clinic of the Howard University Hospital, Washington, DC, were given thorough annual physical examinations and laboratory evaluations of blood and urine. The authors found a significantly high incidence of medical illnesses and abnormal laboratory findings not previously suspected. There was a significant and direct correlation between psychopathology as projected in the Lipman Personality Image Projection (LPIP) test and abnormal laboratory and physical findings. The results in this study concur with previous reports that so-called purely psychogenic stress symptoms may be related to unrecognized medical illnesses. These somatic illnesses may remain unrecognized for indefinite periods of time in the traditional psychiatric outpatient setting from which patients are often referred elsewhere for treatment of nonpsychiatric illness. Initial and periodic physical and laboratory examinations should be performed by psychiatrists trained to recognize nonpsychiatric diseases that often present with psychiatric symptoms. A thorough knowledge of the mind-body relationship is essential to the practice of modern psychiatry.