The identification of psychiatric morbidity by internists and subsequent selection for psychiatric referral

Past literature raises the question as to the degree of identification of psychiatric morbidity among medical inpatients. A psychosocial information scale was used to rate charts of seventeen inpatients who later received a psychiatric consultation and seventeen who did not during the index admission. More psychosocial items were generally present in the charts with those patients receiving later psychiatric consultation overall and specifically in the areas of psychiatric chief complaint, history of behavior change and past psychiatric history. It was concluded that many patients with psychiatric morbidity on medical wards were not so identified and this was a prime reason for their non-referral, although several of the sub-groups of such patients could benefit from psychiatric treatment. Non-psychiatrists were urged to adopt a more holistic approach to medicine with emphasis on continuity of care to insure comprehensive diagnosis and management.