Physical illness in hospitalized psychiatric patients

Extensive investigations including diagnosis based on DSM-III criteria, physical examination, neurological examination, CT scans, EKG, toxicological screening, and biochemical tests were conducted on a randomly selected group of 75 psychiatric inpatients to assess the prevalence of previously undetected physical illnesses. The illnesses that were detected by the research team were divided into those that were (a) incidental, (b) a health burden, and (c) causative of or exacerbating psychiatric illness. Of the 30 physical illnesses which were a health burden, 22 were undetected by the primary psychiatrists. Six of the 18 physical illnesses causing or exacerbating psychiatric illness were identified by the primary psychiatrists. The most useful tool for detection of physical illnesses was physical examination following a standardized systems review and medical history at a time when the patients were able to provide a medical history and cooperate for a physical examination.