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Edited by
Rachel Thomasson, Manchester Centre for Clinical Neurosciences,Elspeth Guthrie, Leeds Institute of Health Sciences,Allan House, Leeds Institute of Health Sciences
It is well established that people suffering from a mental disorder have poorer physical health outcomes, including increased mortality, than those without such a disorder (1). In addition, people with severe mental illness are more likely to be admitted to non-psychiatric medical services, have longer admissions and present with more emergencies (2). The mental health consultation-liaison (CL) team is perfectly placed to ensure holistic assessment and integrated care of this population, with the opportunity to improve both physical and mental health outcomes.
The first interview with a specialist for any patient is important as it allows a bond of trust to be established and the patient to gain confidence in the advice and strategies that the specialist recommends. This bond is more important with infertility patients. A good starting point in history-taking is to enquire about the couple's occupations. Religious, ethnic or cultural background may determine the way they are evaluated and could exclude certain treatment options. After completing the history-taking one should proceed with a physical examination. For the female, a general examination should include vital signs, assessment of the development of secondary sexual characteristics and any sign of endocrine disorders. Physical examination of the male should begin with assessing the secondary sexual characteristics, including body habitus, hair distribution and breast development. By the end of the physical examination, a provisional plan of the investigations and treatment options should be discussed.
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