Psychiatric Morbidity and Referral on Two General Medical Wards

TLDR

Medical clerking should routinely include questions about mood and psychological responses to illness. Psychiatric morbidity was assessed in 230 medical inpatients using a two‑stage screening with the General Health Questionnaire and a Standardized Psychiatric Interview. Of the 230 patients, 23% were psychiatrically ill (affective disorders most common) and 12% were referred, with referral more strongly linked to the illness’s interference with management than to severity or prior history, and half of those with psychiatric illness had problems that were not detected or addressed.

Abstract

Psychiatric morbidity among 230 medical inpatients was determined by a two-stage screening procedure, using the General Health Questionnaire and Standardized Psychiatric Interview. Of these patients, 23% were considered psychiatrically ill, affective disorders being the commonest illnesses encountered; and 27 (12%) were psychiatrically referred. While referral was related to severity of psychiatric illness and previous psychiatric illness, the degree to which the psychiatric illness obtruded or created problems in management appeared more crucial in determining referral. In half of those with psychiatric illness the problems did not appear to have been detected or dealt with. It is suggested that medical clerking should routinely include questions about mood and psychological responses to illness.