Abstract
In Part I of this review73 an attempt was made to outline the scope, organization, and functions of consultation psychiatry in general hospitals. Part II surveys the types of diagnostic and management problems encountered by psychiatric consultants in the medical and surgical divisions of a general hospital. For clarity of presentation, the writer will first review some studies of the prevalence of psychiatric illness in this type of hospital and the frequency of and trends in referrals for psychiatric consultation. While such a survey may give some information about the quantitiative aspects of the problem, it can tell little about the manifold quality of psychopathological and social phenomena which psychiatrists can observe in a medical setting. To do justice to this broader and theoretically far more important aspect, a synopsis of psychiatric aspects of medical practice in a general hospital will be presented. It is expected that such treatment of the subjects will make the review more useful for a wider circle of readers and offer clearer implications for teaching, therapeutic needs, research possibilities, and use of psychiatric manpower.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Ackner B, et al:Acute porphyria:A neuropsychiatrie and biochemical study. J Psychosom Res6:1, 1962
Bard M, Dyk RB:Psychodynamic significance of beliefs regarding the cause of serious illness. Psychoanal Rev43:146, 1956.
Bellak L:Psychology of Physical Illness. New York, Grune & Stratton, 1952.
Beres D, Brenner C:Mental reactions in patients with neurological disease. Psychoanal Quart19:170, 1950.
Biloon S, Karliner W; The clinical picture of manic-depressive equivalents. N Engl J Med259:684, 1958.
Blachly PH:Management of the opiate abstinence syndrome. Am J Psychiat122:742, 1966.
Blachly PH:Procedure for withdrawal of barbiturates. Am J Psychiatry120:894, 1964.
Bleuler M:Akute psychische Veraenderungen bei akuten Koerpererkrankungen. Schweiz Med Wschr92:1521, 1962.
Bleuler M, et al:Akute psychische Begleiterscheinungen K1/4orperlicher Krankheiten. Stuttgart, Thieme, 1966.
Bradley JJ:Severe localized pain associated with the depressive syndrome. Br J Psychiatry 109:741,
Brown W, Pisetsky JE:Suicidal behavior in a general hospital. Am J Med29:307, 1960.
Butler RN, Perlin S:Psychiatric consultations in a research setting. Med Ann DC27:503, 1958.
Chapman LF, Wolff HG:Disease of the neopallium. Med Clin North Am, 42:677, 1958.
Cleghorn RA, Curtis GC:Psychosomatic accompaniments of latent and manifest depressive affect. Can Psychiatr AssocJ4 (suppl):13, 1959.
Conrad K:Die symptomatischen Psychosen, in Gruhle HW ed:Psychiatrie der Gegenwart(Bd 2 ). Berlin, Springer, 1960.
Court JH:Anxiety among acute schizophrenics and temporal lobe patients. BrJSoc Clin Psychol4:254, 1965.
Culpan R, Davis B:Psychiatric illness at medical and surgical outpatient clinic. Compr Psychiatry1:228, 1960.
Cutshall BJ:The Saunders-Sutton syndrome:An analysis of delirium tremens. Q J Stud Alcohol26:423, 1965.
Denney D, et al:Psychiatric patients on medical wards. Arch Gen Psychiatry (Chicago)14:530, 1966.
Dewan JG, Spaulding WB:Thee Organic Psychoses. Toronto, University Press, 1958.
Doust BC:Anxiety as a manifestation of pheochromocytoma. Arch Intern Med (Chicago)102:811, 1958.
Dovenmuehle RH and Verwoerdt A. Physical illness and depressive symptomatology. 1. Incidence of depressive symptoms in hospitalized cardiac patients. J Am Geriatr Soc10:932, 1962.
Eilenberg MD:Psychiatric illness and pernicious anemia. A clinical réévaluation. J Ment Sci106:1539, 1960.
Eilenberg MD:Survey of inpatient referrals to an American psychiatric department. Br J Psychiatry111:1211, 1965.
Engel GL:“Psychogenic” pain and the pain-prone patient. Am J Med26:899, 1959.
Engel GL:Psychological Development in Health and Disease. Philadelphia, WB Saunders Co, 1962.
Engel GL, Romano J:Delirium, a syndrome of cerebral insufficiency. J Chron Dis9:260, 1959.
Essig CF:Newer sedative drugs that can cause intoxication and dependence of barbiturate type. JAMA196:714, 1966.
Ferenczi S:Disease- or pathoneuroses, in Further Contributions to the Theory and Technique of Psycho- Analysis. London, Hogarth Press, 1926.
Fleck U:Symptomatische Psychosen (1941–1957). Fortschr Neurol Psychiatr28. Heft 1, 1960.
Fleminger JJ, Mallett BL:Psychiatric referrals from medical and surgical wards. J Ment Sci108:183, 1962.
Freud S:The justification for detaching from neurasthemia a particular syndrome:The anxiety-neurosis, in Collected Papers. New York, Basic, 1959, vol 1, p 76.
Friedman JH, Cancellieri R. Suicidal risk in a municipal general hospital. Dis Nerv Syst19:556, 1958.
Gatfield PD, Guze SB:Prognosis and differential diagnosis of conversion reactions. Dis Nerv Syst23:623, 1962.
Geocaris K:Psychotic episodes heralding the diagnosis of multiple sclerosis. Bull Menninger Clin21:107, 1957.
Gould J. Virus disease and psychiatric ill-health. Br J Clin Pract11:1, 1957.
Guze SB:A formulation of principles of comprehensive medicine with special reference to learning theory. J Clin Psychol9:127, 1953.
Guze, SB, Cantwell DP:The prognosis in “organic brain” syndromes. Am J Psychiatry120:878, 1964.
Haberland C:Psychiatric manifestations in brain tumors. Akt Fragen Psychiatr Neurol2:65, 1965.
Heisborg HC:Psychiatric investigations of patients in a medical department. Acta Psychiatr Neurol, Scand33:303, 1958.
Henry DW, Mann AM:Diagnosis and treatment of delirium. Can Med Assoc J93:1156, 1965.
Hilkevitch A. Psychiatric disturbances in outpatients of a general medical outpatient clinic. Int J Neuropsychiatry1:371, 1965.
Hohender M:Ambulatory schizophrenia. J Chron Dis9:249, 1959.
Hunter RCA, et al:Nosophobia and hypochondriasis in medical students. J Nerv Ment Dis 139:147,1964.
Janis IL:Psychological Stress. New York, John Wiley & Sons, 1958.
Jonas AD:Ictal and Subictal Neurosis. Springfield, III, Charles C Thomas, 1965.
Jones D, Hall SB:Significance of somatic complaints in patients suffering from psychotic depression. Acta Psychother (Basel)11:193, 1963.
Kahana RJ:Teaching medical psychology through psychiatric consultation. J Med Educ34:1003, 1959.
Kahana RJ, Bibring GL. Personality types in medical management, In Zinberg EN (ed):Psychiatry and Medical Practice in a General Hospital. International Universities Press, 1964, New York.
Kane FJ Jr, Ewing JA:Iatrogenic brain syndrome. South Med J58:875, 1965.
Kaplan SM:Laboratory procedures as an emotional stress. JAMA161:677, 1956.
Kaufman RM:A psychiatric unit in a general hospital. J Mount Sinai Hosp NY24:572, 1957.
Kaufman RM, Bernstein S:A psychiatric evaluation of the problem patient. JAMA163:108, 1957.
Kaufman RM, et al:The emotional impact of ward rounds. J Mount Sinai Hosp NY23:782, 1956.
Kaufman RM, et al:Psychiatric findings in admissions to a medical service in a general hospital. J Mount Sinai Hosp NY26:160, 1959.
Kenyon FE:Hypochondriasis:A clinical study. Br J Psychiatry110:467, 1964.
Kenyon FE:Hypochondriasis:a survey of some historical, clinical and social aspects. Br J Med Psychol38:117, 1965.
Kenyon FE, Rutter ML:The psychiatrist and the general hospital. Compr Psychiatry4:80, 1963.
Kepecs JG:Some patterns of somatic displacement. Psychosom Med15:425, 1953.
Keyes JW:Iatrogenic heart disease. JAMA192:951, 1965.
Klee GD, et al:Pain and other somatic complaints in a psychiatric clinic. Maryland Med J8:188, 1959.
Knight JA:Epidemic hysteria:A field study. Am J Public Health55:858, 1965.
Kolb LC:Anxiety and the anxiety states. J Chron Dis9:199, 1959.
Kornfeld, DS, Feldman M:The psychiatric service in the general hospital. NY State J Med 65:1332,1965
Kornfeld DS, et al:Psychiatric complications of open-heart surgery N Engl J Med273:287, 1965.
Kreitman N:Hypochondriasis and depression in out-patients at a general hospital. Br J Psychiatry111:476, 1965.
Levin M:Delirium:A gap in psychiatric teaching. Am J Psychiatry107:689, 1951.
Lewis BI:A psycho-medical survey of a private out-patient clinic in a university hospital. Am J Med14:586, 1953.
Lewis BI:The hyperventilation syndrome. Ann Intern Med38:918, 1953.
Lewis WC, Berman M:Studies of conversion hysteria. Arch Gen Psychiatry (Chicago)13:275, 1965.
Lindemann E:Hysteria as a problem in a general hospital. Med Clin North Am, 22:591, 1938.
Lipin T:Psychic functioning in patients with undiagnosed somatic symptoms. Arch Neurol Psychiatry73:239, 1955.
Lipowski ZJ:Review of consultation psychiatry and psychosomatic medicine. I. General principles. Psychosom Med29:153, 1967.
Mabry JH:Lay concepts of etiology. J Chron Dis17:371, 1964.
Macrae D:Isolated fear. A temporal lobe aura. Neurology (Minneap)4:497, 1954.
Malmo RB, et al:Specificity of bodily reactions under stress, in Wolff HG (ed):Life Stress and Bodily Disease. Assoc. Research Nervous Mental Disease. Baltimore, Williams & Wilkins, 1950.
Mechanic D:The concept of illness behavior. J Chron Dis15:189, 1962.
Mendelson J, et al:Hallucinations of poliomyelitis patients during treatment in a respirator. J Nerv Ment Dis126:421, 1958.
Merskey H:The characteristics of persistent pain in psychological illness. J Psychosom Res9:291, 1965.
Meyer E:Disturbed behavior on medical and surgical wards:A training and research opportunity, in Masserman JH (ed):Science and Psychoanalysis:Psychoanalytic Education. New York, Grune &; Stratton, 1962, vol 5.
Meyer E, Mendelson M:Psychiatric consultations with patients on medical and surgical wards:Patterns and processes. Psychiatry24:197, 1961.
Meyer E, Mendelson M:The psychiatric consultation in postgraduate medical teaching. J Nerv Ment Dis130:78, 1960.
Miller MH:The borderline psychotic patient:The importance of diagnosis in medical and surgical practice. Ann Intern Med46:736, 1957.
Mittelman B, et al:Personality and psychosomatic disturbances in patients on medical and surgical wards:a survey of 450 admissions. Psychosom Med7:220, 1945.
Nussbaum K:Somatic complaints and homeostasis in psychiatric patients. Psychiatr Quart34:311, 1960.
O’Connor JF, Musher DM:Central nervous system involvement in systemic lupus erythematosus. Arch Neurol (Chicago)14:157, 1966.
Offenkrantz W:Multiple somatic complaints as a precursor of schizophrenia. Am J Psychiatry119:258, 1962.
Payson HE, et al:Recognition and referral of psychiatric illness on a university medical inpatient service. Scientific Proceedings of the 117th Annual Meeting of the American Psychiatric Association, Washington, 1961.
Perlas AP, Faillace LA:Psychiatric manifestations of carcinoma of the pancreas. Am J Psychiatry121:182, 1964.
Poe RO, et al:Depression JAMA195:345, 1966.
Quarton GC, et al:Mental disturbances associated with ACTH and cortisone:A review of explanatory hypotheses. Medicine (Baltimore)34:13, 1955.
Querido A:Forecast and follow-up:an investigation into the clinical, social and mental factors determining the results of hospital treatment. Br J Prev Soc Med13:33, 1959.
Rangell L:Psychiatric aspects of pain. Psychosom Med15:22, 1953.
Reding GR, Daniels RS:Organic brain syndromes in a general hospital. Am J Psychiatry120:800, 1964.
Reid DD:Epidemiological Methods in the Study of Mental Disorders. Geneva, World Health Organization, 1960.
Richman A, et al:Symptom questionnaire validity in assessing the need for psychiatrists’ care. Br J Psychiatry112:549, 1966.
Roberts BH, Norton NM:The prevalence of psychiatric illness in a medical out-patient clinic. N Engl J Med246:82, 1952.
Robinson WG Jr:The toxic delirious reactions of old age, in Kaplan OJ (ed):Mental Disorders in Later Life. Stanford, Stanford University Press, 1956.
Rosenbaum M, Cohen YA:Psychological preparation of the individual for medical and surgical care, in Liebman S (ed):Understanding Your Patient. Philadelphia, JB Lippincott Co, 1957.
Rossman PL:Organic diseases simulating functional disorders. GP28:78, 1963.
Rud F:Psychiatric activities and instruction at a general hospital. J Clin Exp Psychopathol14:139, 1953.
Sand P, et al:Psychological assessment of candidates for a hemodialysis program. Ann Intern Med64:602, 1966.
Sandt JJ, Leifer R:The psychiatric consultation. Compr Psychiatry5:409, 1964.
Saunders L:Cultural Differences and Medical Care. New York, Russell Sage Foundation, 1954.
Schilder P:The Image and Appearance of the Human Body. New York, International Universities Press, 1950.
Schwab JJ, et al:Differential characteristics of medical in-patients referred for psychiatric consultation:A controlled study. Psychosom Med27:112, 1965.
Schwab JJ, et al:Medical patients’ reactions to referring physicians after psychiatric consultation. JAMA195:1120, 1966.
Schwab JJ, et al:Problems in psychosomatic diagnosis:I. A controlled study of medical inpatients. Psychosomatics6:369, 1964.
Schwab JJ, et al.Problems in psychosomatic diagnosis:II. Severity of medical illness and psychiatric consultations. Psychosomatics6:69, 1965.
Schwab JJ, et al.Problems in psychosomatic diagnosis:III. Physical examinations, laboratory procedures, and psychiatric consultations. Psychosomatics6:147, 1965.
Schwab JJ et al:Problems in psychosomatic diagnosis:IV. A challenge to all physicians. Psychosomatics6:198, 1965.
Scitz PFD:Symbolism and organ choice in conversion reactions. Psychosom Med13:254, 1951.
Senescu RA:The development of emotional complications in the patient with cancer. J Chron Dis16:813, 1963.
Shepherd M et al:Psychiatric illness in the general hospital. Acta Psychiatr Neurol Scand35:518, 1960.
Simon A, Cahan RB:The acute brain syndrome in geriatric patients. Psychiatr Res Rep Am Psychiatr Assoc, May 16, 1963.
Slater E:Diagnosis of “hysteria.” Br Med J1:1395, 1965.
Small IF et al:Organic cognates of acute psychiatric illness. Am J Psychiatry122:790, 1966.
Spencer RF. Medical patients:Consultation and psychotherapy. Arch Gen Psychiatry (Chicago)10:270, 1964.
Starr AM:Personality changes in Cushing’s syndrome. J Clin Endocrinol. 12:502, 1952.
Stenbäck A, Rimon R:Hypochondria and paranoia. Acta Psychiatr Scand49:379, 1964.
Stengel E:Pain and the psychiatrist. Br J Psychiatry111:795, 1965.
Stewart MA et al:A study of psychiatric consultations in a general hospital. J Chron Dis15:331, 1962.
Stewart MA et al:Depression among medically ill patients. Dis Nerv Syst26:479, 1965.
Stoeckle JD, Davidson GE:Bodily complaints and the other symptoms of a depressive reaction, its diagnosis and significance in a medical clinic. JAMA180:134, 1962.
Stoeckle JD, Davidson GE:The use of “crisis” as an orientation for the study of patients in a medical clinic. J Med Educ37:604, 1962.
Stoeckle JD et al:The quantity and significance of psychological distress in medical patients. J Chron Dis17:959, 1964.
Stoller RJ, Estess FM:Suicides in medical and surgical wards of general hospitals. J Chron Dis12:592, 1960.
Szasz TS; Pain and Pleasure, New York, Basic, 1957.
Tavel ME:Hyperventilation syndrome with unilateral somatic symptoms. JAMA187:301, 1964.
Veith I:Hysteria. The History of a Disease. Chicago, University of Chicago Press, 1965.
Walters A:Psychogenic regional pain alias hysterical pain. Brain84:1, 1961.
Weinstock HI:Discussion of schizophrenia in:Early recognition and management of psychiatric disorders in general practice. J Mount Sinai Hosp NY 25:137, 1958.
Weisman AD, Hackett TP:Psychosis after eye surgery. N Engl J Med258:1284, 1958.
Wilson MS, Meyer E:Diagnostic consistency in a psychiatric liaison service. Am J Psychiatry119:207, 1962.
Wilson M. Meyer E:The doctors vs. the nurses’ view of emotional disturbances. Can Psychiatr Assoc J10:212, 1965.
Ziegler E J et al:Contemporary conversion reactions:A clinical study, Am J Psychiatry116:901, 1960.
Ziegler FJ, Imboden JB:Contemporary conversion reactions. II. A conceptual model. Arch Gen Psychiatry (Chicago)6:279, 1962.
Ziegler FJ et al:Contemporary conversion reactions. III. Diagnostic considerations. JAMA 186:307,1963
Zwerling I et al:Personality disorder and the relationship of emotion to surgical illness in 200 surgical patients. Am J Psychiatry112:270, 1955.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 1985 Plenum Publishing Corporation
About this chapter
Cite this chapter
Lipowski, Z.J. (1985). Review of Consultation Psychiatry and Psychosomatic Medicine. In: Psychosomatic Medicine and Liaison Psychiatry. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2509-3_19
Download citation
DOI: https://doi.org/10.1007/978-1-4613-2509-3_19
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4612-9517-4
Online ISBN: 978-1-4613-2509-3
eBook Packages: Springer Book Archive