Psychiatric Consequences of Physical Illness — Clinical Aspects: Discussion

Abstract

The diagnostic concepts in ICD-9 associated with the topic psychiatric consequences of physical illness are summarized in Fig. 1. A narrow definition would restrict the topic to “organic” states, such as delirium. However, our understanding of the psychiatric consequences of physical illness would be increased by including clinical experiences and research results from a broader perspective of the soma-psyche relationship. This is represented in the middle and right-hand parts of the figure. Some reasons for such a view are that:

• 1. Physical illnesses are mainly treated in medical departments, which do not involve psychiatry. In that setting, their mental consequences will be seen only as epiphenomena or disturbing complications, and these are often treated without psychiatric intervention or insight.

• 2. The typical psychopathology of organic brain syndromes, i.e., delirium and dementia, has been broadened, since mild, incipient, or reversible brain disorders have been added to the more severe conditions.

• 3. The diagnostic study of both structural and functional brain disturbances is now being approached in more sophisticated ways — in quaUtative, spatial, and temporal terms.