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5 - Detection of psychiatric disorders in the general hospital

from Part I - Basic skills

Published online by Cambridge University Press:  10 December 2009

By
Damien Longson
Edited by
Geoffrey Lloyd  and
Elspeth Guthrie
Geoffrey Lloyd
Affiliation:
Priory Hospital, London
Elspeth Guthrie
Affiliation:
University of Manchester
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Summary

Introduction

Trainees in liaison psychiatry are frequently surprised to find that the detection and management of psychiatric disorders in the general hospital is a complex and time-consuming process. Liaison psychiatrists need to integrate a broad range of skills – communication, clinical, diagnostic, medical, legal and pharmacological. Interviewing patients in challenging situations, for example on intensive care units or following maxillo-facial surgery, requires the development of unique clinical skills and a certain amount of improvisation. This chapter considers those aspects of psychiatric assessment that are unique to the general hospital, and offers guidance on the assessment of the most prevalent psychiatric symptoms. The supportive use of objective questionnaires is also considered.

Clinical skills

Information gathering

The assessment process starts as soon as the referral is received. Ideally, the referral should ask a specific question about a patient's psychological health, or ask for guidance on the psychological components of a more complex management problem (for example in situations where capacity to consent is a problem). Often, a telephone call to the referrer clarifies the nature of the clinical conundrum, and it helps establish whether the referral has been made with the agreement of both the patient and the patient's senior physician. Previous psychiatric notes should be obtained at this stage.

It is essential to telephone the ward prior to the consultation to establish a mutually convenient time for both the patient and the ward staff.

Keywords

anxietydepressiongeneral hospitalliaison psychiatryrating scalespsychiatric assessmentpsychiatric disorder
Type
Chapter
Information
Handbook of Liaison Psychiatry , pp. 83 - 101
Publisher: Cambridge University Press
Print publication year: 2007

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