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23 - General hospital psychiatry

from Section 4 - Psychiatry in Specific Settings

Published online by Cambridge University Press:  22 August 2009

Robin M. Murray
Affiliation:
King's College London
Kenneth S. Kendler
Affiliation:
Virginia Commonwealth University
Peter McGuffin
Affiliation:
University of Wales College of Medicine
Simon Wessely
Affiliation:
Institute of Psychiatry, London
David J. Castle
Affiliation:
University of Melbourne
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Summary

This chapter deals with a description of some of the general themes that are pertinent across all disorders in their presentation within general hospitals. Mental health services in general hospitals see only a tiny minority of all those with psychiatric disorders. Depression and anxiety are common in general hospital patients, and there is a strong epidemiological association between physical disease and common mental disorders in the wider population. Few studies have described the natural history of depression and anxiety in medically ill patients. There is a close association between psychiatric disorders and unexplained symptoms. Many patients with unexplained symptoms are prescribed antidepressants. A common reason for referral to liaison psychiatrists is to determine whether a patient has mental capacity or competence to make a treatment decision. Such patients tend to be older, have more cognitive impairment and neurological disorders than patients who have mental capacity.
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Essential Psychiatry , pp. 515 - 539
Publisher: Cambridge University Press
Print publication year: 2008

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