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Chapter 19 - Psychiatry in the General Hospital

Published online by Cambridge University Press:  04 April 2024

By
Parashar Ramanuj  and
Alice Ashby
Edited by
David Kingdon ,
Paul Rowlands  and
George Stein
David Kingdon
Affiliation:
University of Southampton
Paul Rowlands
Affiliation:
Derbyshire Healthcare NHS foundation Trust
George Stein
Affiliation:
Emeritus of the Princess Royal University Hospital
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Summary

CL psychiatry is one of the newer sub-specialties of adult psychiatry and is concerned with the practice of psychiatry in non-psychiatric settings. Typically, this means in general hospital wards and outpatient clinics, although in some countries, it also includes liaison with primary care. In recent years, there have been important changes in general medicine relevant to CL psychiatry. There is now a much wider recognition of the high prevalence of psychiatric and physical comorbidity and how this influences consultation frequency, service utilisation, treatment adherence, the physical prognosis and probably the overall cost as well. The relationship between physical disease and mental disorder is influenced by biological factors contributing to psychological change in physical disease, psychological factors in physical disease, social factors and comorbidity. There has also been recognition of the high prevalence of non-organic complaints among general medical patients as well as an awareness of the high costs of investigating these patients, which has led to a search for better ways to manage this group of patients.

Collaboration between general medical and psychiatric staff is essential. Psychological treatment and psychotropic medication can be effective. Mental capacity is an important and sometimes complex issue.

Keywords

consultation-liaison psychiatryrelationship between physical disease and mental disorderbiological factors contributing to psychological change in physical diseasepsychological factors in physical diseasesocial factorscomorbiditysuicidepsychological treatmentpsychotropic medicationmental capacityservice provision
Type
Chapter
Information
Seminars in General Adult Psychiatry , pp. 739 - 766
Publisher: Cambridge University Press
Print publication year: 2024

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