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Psychiatric Screening of Admissions to an Accident and Emergency Ward

Published online by Cambridge University Press:  03 January 2018

Gary Bell ,
Dan Z. Reinstein ,
Gitendra Rajiyah  and
Rachel Rosser
Gary Bell*
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
Dan Z. Reinstein
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
Gitendra Rajiyah
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
Rachel Rosser
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
*
∗Senior Lecturer, Department of Psychological Medicine, Medical College of St Bartholomew's Hospital, West Smithfield, London EC1A 7BE
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Abstract

One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 4 , April 1991 , pp. 554 - 557
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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References

Bell, G., Hindley, N., Rajiyah, G., et al (1990) Screening for psychiatric morbidity in an accident and emergency department. Archives of Emergency Medicine, 7, 154–162.Google Scholar
Bluglass, D., Duffy, K. & Kreitman, N. (1980) A register of social and medical indices by local government area in Edinburgh and Lothians. Edinburgh: Scottish Office Central Research Papers.Google Scholar
Bridges, K. & Goldberg, D. P. (1984) Psychiatric illness in patients with neurological disorders: patients' views on discussion of emotional problems with neurologists. British Medical Journal, 289, 656–658.Google Scholar
Catalan, J., Marsack, P., Hawton, K. E., et al (1980) Comparison of doctors and nurses in the assessment of deliberate self-poisoning patients. Psychological Medicine, 10, 483–491.Google Scholar
Feldman, E., Mayou, R., Hawton, K., et al (1987) Psychiatric disorder in medical in-patients Quarterly Journal of Medicine, 63, 405–412.Google Scholar
Gibbons, J. L., Jennings, C. & Wing, J. K. (1983) Psychiatric Care in Eight Register Areas: Statistics from Eight Psychiatric Case Registers in Britain, 1976–1981. Southampton Psychiatric Case Register, Knowle Hospital, Fareham, Hants PO17 5NA.Google Scholar
Goldberg, D. (1972) The Detection of Psychiatric Illness by Questionnaire. Maudsley monograph no. 21. London: Oxford University Press.Google Scholar
Goldberg, D. (1978) Manual of the General Health Questionnaire. Windsor: NFER-Nelson.Google Scholar
Goldberg, D. (1985) Identifying psychiatric illness among general medical patients. British Medical Journal, 291, 161–162.CrossRefGoogle ScholarPubMed
Goldberg, D., Cooper, A. B., Eastwood, M. R., et al (1970) A standardised interview suitable for use in community surveys. British Journal of Preventative and Social Medicine, 24, 18–24.Google Scholar
Hawton, J. (1981) The long-term outcome of psychiatric morbidity detected in general medical patients. Journal of Psychosomatic Research, 25, 237–243.Google Scholar
Hirsch, S. R. (1988) Psychiatric Beds and Resources: Factors Influencing Bed Use and Service Planning. London: Gaskell.Google Scholar
Jarman, B. (1983) Identification of underprivileged areas. British Medical Journal, 286, 1705–1709.Google Scholar
Jarman, B. (1984) Underprivileged areas: validation and distribution of scores. British Medical Journal, 289, 1587–1592.Google Scholar
Maguire, G. P., Julier, D. L., Hawton, K. E., et al (1970) Psychiatric morbidity and referral on two general medical wards. British Medical Journal, i, 268–270.Google Scholar
Malt, U., Myhrer, T., Blikra, G., et al (1987) Psychopathology and accidental injuries. Acta Psychiatrica Scandinavica, 76, 261–271.Google Scholar
Mayou, R. & Hawton, K. (1986) Psychiatric disorder in the general hospital. British Journal of Psychiatry, 149, 172–190.CrossRefGoogle ScholarPubMed
Mayou, R., Hawton, K. & Feldman, E. (1988) What happens to medical patients with psychiatric disorder? Journal of Psychosomatic Research, 32, 541–549.Google Scholar
Moffic, H. & Paykel, E. S. (1975) Depression in medical inpatients. British Journal of Psychiatry, 126, 346–353.Google Scholar
Newton-Smith, J. G. B. & Hirsch, S. R. (1979) A comparison of social workers and psychiatrists in evaluating parasuicide. British Journal of Psychiatry, 134, 335–342.Google Scholar
Royal College of Psychiatrists (1989) Comments of the Royal College of Psychiatrists on the NHS White Paper: ‘Working for Patients’. Psychiatric Bulletin, 13, 385–389.CrossRefGoogle Scholar
Zigmond, A. S. & Snaith, R. P. (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar
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