Skip to main content

Differentiating Physical from Psychiatric Disorders

  • Chapter
Handbook of Outpatient Treatment of Adults

Abstract

In 1980, the American Psychiatric Association restated the need for careful medical evaluation of psychiatric patients by incorporating physical disorders as one of three diagnostic axes. In its third edition of the Diagnostic and Statistical Manual (DSM-III), the diagnostic criteria further require the exclusion of physical causes of mental symptoms: the clinician must determine that the diagnoses of Axis I are “not due to an organic mental disorder.” The impact of these changes is profound: the psychiatrist must consider the effects that an underlying medical disorder may have in producing specific psychiatric symptoms, and he or she must examine and further evaluate patients to rule out such disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alstrom, C. H. (1942). Mortality in mental hospitals. Acta Psychiatrica et Neurologica Scandinavica, 17 (suppl. PPL-24).

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders ( 3rd ed.; DSM-III). Washington DC: Author.

    Google Scholar 

  • Babigiam, H. W., and Odoroff, C. L. (1969). The mortality experience of a population with psychiatric illness. American Journal of Psychiatry, 126 (4), 470–480.

    Google Scholar 

  • Bell, R. C., and Hall, R. C. W. (1977). The mental status examination. American Family Physician, 16 (5), 145–152.

    PubMed  Google Scholar 

  • Beresford, T. P., Blow, R. C., Hall, R. C. W., Nichols, L. O., and Langston, J. W. (1985). Focal signs and brain

    Google Scholar 

  • CT scans in psychiatric patients (Letter to the Editor). New England Journal of Medicine, 313,388.

    Google Scholar 

  • Bonhoffer, D. (1912). Die Psyhosem im Gefolge von akuten Infektionem Allgemeiner Krankunger. In: G. L. Aschaffenbeg (Ed.), Handbauch der Psychiatrie ( 3rd ed., pp. 1–60 ). Leipzig Germany: Deuticke.

    Google Scholar 

  • Boston Collaborative Drug Surveillance Study. (1971). Psychiatric side effects of non-psychiatric drugs. Seminars in Psychiatry, 3, 406–420.

    Google Scholar 

  • Bunce, D. F.M., II, Jones, L. R., Badger, L. W., and Jones, S. E. (1982). Medical illness in psychiatric patients: Barrier to diagnoses and treatment. Southern Medial Journal, 75, 941–944.

    Article  Google Scholar 

  • Dorfman, W., and Christofar, L. (Eds.). (1985). Psychosomatic Illness Review. New York: Macmillan.

    Google Scholar 

  • Eastwood, M. R., and Trevelyan, M. H. (1972). Relationship between physical and psychiatric disorders. Psychological Medicine, 2 363–372.

    Article  PubMed  Google Scholar 

  • Hall, R. C. W. (Ed.). (1980). Psychiatric presentation of medical illness: Somatopsychic disorders. Jamaica NY: Spectrum.

    Google Scholar 

  • Hall, R. C. W., and Beresford, T. P. (1983a) Laboratory evaluation of newly admitted psychiatric patients. In: R. C. W. Hall and T. P. Beresford (Eds.), Handbook of psychiatric diagnostic procedures (pp. 255–314 ). Jamaica NY: Spectrum.

    Google Scholar 

  • Hall, R. C. W., and Beresford, T. P. (1983b). Psychiatric manifestations of physical illness. In: J. O. Cavenar, Jr. (Ed.), Psychiatry (Vol. 2, Chapter 88, pp. 1–18 ). New York: Lippincott.

    Google Scholar 

  • Hall, R. C. W., and Beresford, T. P. (Eds.). (1983–1984). Handbook of Psychiatric Diagnostic Procedures (Vols. 1 and 2). Jamaica NY: Spectrum.

    Google Scholar 

  • Hall, R. C. W., Popkin, M. K, and Devaul, R. A. (1977). The effect of unrecognized drug abuse on diagnosis and therapeutic outcome. American Journal of Drug and Alcohol Abuse, 4 (4), 455–465.

    Article  PubMed  Google Scholar 

  • Hall, R. C. W., Popkin, M. K., Devaul, R. A., Faillace, L. A., and Stickney, S. K. (1978) Physical illness presenting as psychiatric disease. Archives of General Psychiatry, 35, 1315–1320.

    Article  PubMed  Google Scholar 

  • Hall, R. C. W., Gardner, E. R., Stickney, S. K., LeCann, A. F., and Popkin, M. K. (1980). Physical illness manifesting as psychiatric disease: 2. Analysis of a state hospital inpatient population. Archives of General Psychiatry, 37, 989–995.

    Article  PubMed  Google Scholar 

  • Hall, R. C. W., Levenson, A. J., and LeCann, A. F. (1981). Evaluation and assessment of non-functional psychiatric illness in the elderly. In: A. J. Levenson and R. C. W. Hall (Eds.), Neuropsychiatric manifestations of physical disease in the elderly (pp. 133–149 ). New York: Raven Press.

    Google Scholar 

  • Hall, R. C. W., Gardner, -E. R., Popkin, M. K., and LeCann, A. F. (1981). Unrecognized physical illness prompting psychiatric admission: A prospective study. American Journal of Psychiatry, 138(5), 629–635.

    Google Scholar 

  • Hall, R. C. W., Beresford, T. P., Gardner, E. R., and Popkin, M. K. (1982). The medial care of psychiatric patients. Hospital and Community Psychiatry, 33 (1), 25–34.

    PubMed  Google Scholar 

  • Hoffman, R. S. (1982). Diagnostic errors in the evaluation of behavioral disorders. Journal of American Medical Association, 2 (48), 964–967.

    Article  Google Scholar 

  • Hoffman, R. S., and Koran, L. M. (1984). Detecting physical illness in patients with mental disorders. Psychosomatics, 25 (9), 654–659.

    Article  PubMed  Google Scholar 

  • Jefferson, J. W., and Marshall, R. R. (1981). Neuropsychiatric features of medical disorders. New York: Plenum Press.

    Google Scholar 

  • Koran, L. M. ( 1985, November). Physical illness in a sampling of California psychiatric patients. Paper presented at the Academy of Psychosomatic Medicine 32nd Annual Meeting.

    Google Scholar 

  • Koranyi, E. K. (1972). Physical health and illness in a psychiatric outpatient department population. Canadian Psychiatric Association Journal, 17, 109–116.

    Google Scholar 

  • Koranyi, E. K. (1982). Physical illness in the psychiatric patient. Springfield IL: Charles C Thomas.

    Google Scholar 

  • LaBruzza, A. L. (1981). Physical illness presenting as psychiatric disorder: Guidelines for differential diagnosis. Journal of Operational Psychiatry, 12, 24–31.

    Google Scholar 

  • Leishman, W. A. (1978) Organic psychiatry. Oxford, England: Blackwell Scientific Publication.

    Google Scholar 

  • Malzberg, B. (1952). Rates of discharge and rate of mortality among first admissions to the New York civil state hospitals. Mental Hygiene, 36, 104–120.

    PubMed  Google Scholar 

  • Odegard, O. (1951). Mortality in Norwegian mental hospitals 1926–1941. Acta Genetica et Statistica Medica, 2, 141–173.

    PubMed  Google Scholar 

  • Odegard, O. (1953). The excess mortality of the insane. Acta Psychiatrica et Neurologica Scandinavica, 27, 353–367.

    Article  Google Scholar 

  • Paffenbarger, R. S., Jr., and Wing, A. L. (1967). Characteristics in youths predisposing to fatal stroke in later years. Lancet, 1, 753–754.

    Article  PubMed  Google Scholar 

  • Paffenbarger, R. S., Jr., Wolf, P. A., Notkin, J., and Thorne, M. C. (1966). Chronic disease in former college students: 1. Early precursors of fatal coronary heart disease. American Journal of Epidemiology, 83, 314–328.

    PubMed  Google Scholar 

  • Paffenbarger, R. S., Jr., Notkin, J., Kreuger, D. E., Wolf, P. A., Thorne, M. C., LeBauer, E. J., and Williams, J. L. (1966). Chronic disease in former college students: 2. Methods of study and observations on mortality for chronic heart disease. American Journal of Public Health, 56, 962–971.

    Article  PubMed  Google Scholar 

  • Paffenbarger, R. S., Jr., Thorne, M. C., and Wing, A. L. (1968). chronic disease in former college students: 8. Characteristics in youths predisposing to hypertension in later years. American Journal of Epidemiology, 88, 25–32.

    Google Scholar 

  • Pokorny, A. D., and Frazier, S. H. (1966). Report of the administrative survey of Texas state mental hospitals. Austin: Austin Foundation for Mental Health Research Texas Department of Mental Health and Mental Retardation.

    Google Scholar 

  • Roessler, R., and Greenfield, N. S. (1961). Incidence of somatic disease in psychiatric patients. Psychosomatic Medicine, 23 (5), 413–419.

    PubMed  Google Scholar 

  • Struve, F. A. (1980). Utilization of clinical electroencephalographic assessment in the psychiatric hospital: Routine vs. selective physician referral. Journal of Psychiatric Treatment and Evaluation, 2, 55–62.

    Google Scholar 

  • Summers, W. K., Munoz, R. A., Read, M. E., and Marsh, G. M. (1981). The psychiatric physical examination: 2. Findings in 75 unselected psychiatric patients. Journal of Clinical Psychiatry, 42 (3), 99–102.

    PubMed  Google Scholar 

  • Thomas, C. B., and Duezynski, W. R. (1974). Closeness to parents in the family constellation in a prospective study of five disease states: Suicide, mental illness, malignant tumor, hypertension and coronary heart disease. Johns Hopkins Medical Journal, 143, 251–270.

    Google Scholar 

  • Vaillant, G. E. (1978a) Adaptation to life. Boston: Little Brown.

    Google Scholar 

  • Vaillant, G. E. (1978b). Natural history of male psychological health: 4. What kinds of men do not get psychosomatic illnesses. Psychosomatic Medicine, 40, 420–432.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer Science+Business Media New York

About this chapter

Cite this chapter

Hall, R.C.W., Beresford, T.P., Blow, F.C., Hall, A.K. (1990). Differentiating Physical from Psychiatric Disorders. In: Thase, M.E., Edelstein, B.A., Hersen, M. (eds) Handbook of Outpatient Treatment of Adults. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0894-0_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-0894-0_2

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-0896-4

  • Online ISBN: 978-1-4899-0894-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics