Oxford Textbook of Medicine (6 edn) - The psychiatric assessment of the medical patient: Sharpe et al

[Sly Saint]

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Chapter:
The psychiatric assessment of the medical patient
Author(s):
Jane Walker
, Roger Smyth
, and Michael Sharpe
DOI:
10.1093/med/9780198746690.003.0620

Medically ill patients often have psychiatric illness. Physicians can and should detect and diagnose these illnesses during their standard medical assessment. All that is required is knowledge of key questions to ask patients, awareness of the clinical signs that may be observed, and an appreciation of the value of additional information from relatives, other clinicians, and the medical record.
The aims are to detect and diagnose psychiatric disorders; assess the risk of self-harm or harm to others; establish the need for treatment or referral for a psychiatric opinion; provide the basis for clear and effective communication with a psychiatrist; and to communicate to the patient that you are interested in all aspects of their suffering and thereby establish a clinically effective relationship with them.

https://oxfordmedicine.com/view/10.1093/med/9780198746690.001.0001/med-9780198746690-chapter-620

 

[Arnie Pye]

My emphasis :

Medically ill patients often have psychiatric illness. Physicians can and should detect and diagnose these illnesses during their standard medical assessment.

Which one of these sentences is the one we're supposed to assume is the one intended?

1) Physicians can and should detect and diagnose these physical illnesses
2) Physicians can and should detect and diagnose these mental illnesses

 

[Sly Saint]

The whole concept is totally back to front.
Say someone finds a lump. Unsurprisingly they become anxious about it, try to get a doctors appointment and find the first available one is in 3 weeks time. Naturally, they continue to feel more anxious, maybe start to lose sleep, so feel more tired, unable to concentrate etc.

Finally they get to see a doctor who then, after examination of said lump, decides the patient also has anxiety so as well as booking them for a hospital appointment (for which they might have to wait several weeks more) to have the lump checked, refer them for a cbt course; of course I don't think, from what I have read, that it is that straightforward even under IAPT. So now they get even more anxious by people asking them about all sorts of non-related issues that might be 'causing' their anxiety.

How is this helping the patient, and how is it cost efficient?

 

[EzzieD]

Medically ill patients often have psychiatric illness.

'Often'? Really? Are they sure they didn't mean 'occasionally' but just spelled it wrong ? But seriously, can they produce actual evidence (real statistics, not something just made up in their own heads) that this is often the case? Nope, didn't think so...

 

[John Mac]

Is this book part of the series "The idiots guide to........."

 

[Invisible Woman]

Was it an add for Heineken that claimed it was the beer that could reach parts others can't?

Is Michael Sharpe trying to claim psychiatry is the "Heineken" of the medical world?

Unlike Heineken, whose fans presumably like it and derive some satisfaction and pleasure from drinking it, psychiatry seems to satisfy very few of it's patients while it continually advertises for new ones. It certainly doesn't cure many.

Still, I'd be very happy to let Prof Sharpe examine all the patients with haemorrhoids. Perhaps he can fix those?