The pattern of in-patient psychiatric referrals in a general hospital

All patients referred for a psychiatric consultation from the adult wards of a General Hospital over a 10-month period were examined. The referral rate was 1.4%. Twice as many female patients were referred as male patients. Parasuicide accounted for 68% of referrals. The most common psychiatric diagnoses were adjustment reaction (41%), depression (23%), alcohol dependence (5%) and schizophrenia (5%). In 30% of referrals, no psychiatric treatment was necessary; 26% were transferred to the psychiatric unit and 17% were discharged to the out-patients' psychiatric clinic. Explanations are offered for the "hidden" psychiatric morbidity in General Hospitals and the high percentage of referrals who did not need psychiatric follow-up. Suggestions are made for a better liaison between physicians and psychiatrists.