Hospital doctors are increasingly recognising that in many
patients medical illness is accompanied by psychological distress
that also requires intervention. For many patients the general
hospital is often a way into psychiatric care, for example for
those with somatic symptoms, following deliberate self-harm or with
complications of drug and alcohol misuse.
This joint report from the Royal College of Physicians and
Royal College of Psychiatrists aims to highlight the importance of
addressing the psychological dimension of medical practice and to
foster the development of services designed to improve the
psychological care of medical patients. The latter target is best
achieved by establishing a multidisciplinary liaison psychiatry
service in every general hospital.
There is a high prevalence of psychiatric disorders in general
hospital patients, including depression, anxiety disorders,
delirium and substance misuse. Many patients with significant and
persistent psychological symptoms respond well to psychological or
pharmacological treatments, or therapeutic interventions. Thus,
physicians need to be able to identify these problems, to arrange
basic psychological care and know when to refer patients to
specialist psychiatric and psychological services. This report is a
practical guide which addresses these issues, outlines the common
psychiatric syndromes and advises on their recognition and
management.
The report includes chapters on the following areas:
- Communication and psychological assessment
- Psychological responses to illness
- Medically unexplained symptoms
- Management of psychological problems
- Deliberate self-harm
- Alcohol and drug misuse
- Dementia, delirium and organic mood disorders
- The Mental Health Act 1983, common law and consent to
treatment
- Developing a liaison service.
(This report replaces CR35. The Psychological Care of Medical
Patients: recognition and need of service provision from
1995.)