Physical disease in the chronic mentally ill

A group of 196 institutionalized patients with chronic mental illness was studied to determine the prevalence of unrecognized physical disease. Sixty per cent of the patients were found to have previously undiagnosed minor or major disorders, the most prevalent being scabies and fungal infections (24%), peripheral vascular disease (13%), dyskinetic movements (11%) and anaemia (5,5%). Forty-six per cent of the physical disorders were considered to be minor, and only 21% of the major disorders were likely to respond to treatment. In particular there was a striking correlation between peripheral vascular disease and Korsakoff's psychosis. This study shows that there is a need for regular on-going physical assessment of such patients.