Experiences in childhood can have a tremendous influence on wellbeing in adulthood, and on the ways in which illness presents in adulthood. Conversely, illness in a parent, and the way the illness is managed, can have a great impact on the children in the family. This chapter examines these two areas, examining the knowledge base and the implications for practice in adult liaison psychiatry. Child sexual abuse is the environmental factor which has the greatest influence on those areas of adult functioning which are of interest to the liaison psychiatrist. Mental health problems in childhood are common. Some of these conditions are short lived. However, many conditions persist, in varying form, into adulthood, including anxiety, depression, eating disorders and conduct disorder. Children bereaved of a parent have higher rates of morbidity, and substantial numbers meet diagnostic criteria for major depressive disorder in the first year after parental death.

Genitourinary medicine (GUM) attracted the attention of liaison psychiatrists decades before the emergence of HIV. Although many psychiatrists are accustomed to working in HIV departments, fewer contemporary practitioners have experience of general GUM clinics. The sections of this chapter describes specific illnesses found in GUM settings. Where applicable, the relevance of various International Classification of Disease (ICD)-10 diagnoses is discussed. Almost any psychiatric condition may exist comorbidly in patients attending GUM clinics. The conditions described in the sections are therefore clinical pictures where psychiatry and GUM overlap through more than a chance association. The high levels of psychological disturbance in GUM clinics are not matched by high levels of referral to psychiatrists. Although any number from 20 to 50% of patients may score as distressed, fewer than 1% are referred to mental health services.