Psychiatric consultations in a general hospital. A report on 1,000 referrals

1,000 medical and surgical inpatients referred for psychiatric consultation showed concurrent physical and psychiatric disorder in 68.2% of cases. This is in accordance with epidemiological findings that these two types of morbidity have a positive association and coexist in 20-50% of patients. Depression was the commonest psychiatric disorder in all classes of organic disease and accounted for 53% of all psychiatric diagnoses. Organic brain syndromes, acute and chronic, constituted 18% of referrals. Almost twice as many women as men were referred despite their nearly equal distribution in hospital population. One third of the females had no positive medical diagnosis compared to one fifth of the men. Alcoholism was a major problem in 8.9% of referrals. 7.8% of patients were referred following suicidal attempt. Of the 50 patients with cancer, 66% had depression. Too few medical patients with psychiatric complications are referred and adequately treated. Greater emphasis on teaching psychiatric syndromes is called for. Psychiatric consultation liaison services offer the most direct form of collaboration between psychiatry and medicine in the interests of comprehensive patient care.