Psychiatric Referrals in a General Hospital

Bridges, P. K.; Koller, K. M.; Wheeler, Timothy

doi:10.1111/j.1600-0447.1966.tb01923.x

Cited by 33 publications

(10 citation statements)

References 18 publications

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Section: Methodsmentioning

confidence: 99%

“…Percentage of psychiatric Specialty morbidity (or of Percentage of referrals 'functional disorders') to the psychiatrist General medicine 43-5 (Pemberton, 1951) 14 (Fleminger & Mallett, 1962) 38-51 3-8 (Kenyon & Rutter, 1963) 16-2 (Priest, 1962 04-2-8 (Bridges, Koller & Wheeler, 1966) 26 (Maclay, 1965) 4'2 (Crisp, 1968) 14 (Forsyth & Logan, 1968) Neurology 5 (Jacobs & Russell, 1961) 4-6 (Crisp, 1968) General surgery 5-21 0-16 (Fleminger & Mallett, 1962) 0-37 (Kenyon & Rutter, 1963) 2 (Crisp, 1968) Gynaecology 38 (Morris & O'Neill, 1958) 0-18 (Fleminger & Mallett, 1962) 10 (Munro, 1969) 0-59 (Kenyon & Rutter, 1963) All specialties 0-7 (Fleminger & Mallett, 1962) The lack of readily available psychiatric facilities The patients' dislike of being referred to a psychiatrist The disadvantage to patients of being labelled as mental cases Psychological complaints are often made worse by medical attention Psychiatric illness is largely incurable A feeling that treatment of neurotic patients is the job of any doctor The delay in receiving reports on patients referred to psychiatric clinic Lack of satisfactory rapport between you and the psychiatrist Unsatisfactory division of responsibility Any others sent to 106 consultants comprising all non-psychiatric clinicians who were on the staff of six hospitals in the area of the North East Metropolitan Regional Board. The hospitals were selected for the comprehensive nature of their clinical service and the demographic variety of the areas served by them.…”

Section: Methodsmentioning

confidence: 99%

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Reasons against referral to the psychiatrist

Mezey

Kellett

1971

Postgraduate Medical Journal

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SummaryConsultants practising clinical specialties other than psychiatry in six general hospitals were asked by questionnalre about reasons which might prevent the referral of patients to a psychiatrist. The purpose of the enquiry was to find out the causes of the discrepancy between the prevalence of psychiatric disorder among medical and surgical patients and the low rate of referral.Forty-five per cent of the consultants were influenced by the patient's dislike of referral; there was also evidence of marked dissatisfaction with existing psychiatric services at certain hospitals, felt chiefly by the younger consultants. Part-time consultants gave more reasons for non-referral, but there was no significant difference between medical and surgical specialties despite reported variations in referral practice.It is concluded that general hospital psychiatric units have a role to play in improving the relationship between psychiatrists and other specialties so that referral practice can meet the needs of the patient. IntroductionSeveral surveys have shown a discrepancy between the incidence of psychiatric disorder in patients attending non-psychiatric departments of general

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Reasons against referral to the psychiatrist

Mezey

Kellett

1971

Postgraduate Medical Journal

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“…In a comparative study Cassidy, Flanagan & Spellman (1957) found that headaches were reported by 49%/ of depressed patients, 36%Y of medically sick controls and as many as 25%4 of healthy controls. Bridges, Koller & Wheeler (1966) reported on a group of patients in a general hospital who were referred for psychiatric assessment because no organic cause had been found for their physical complaints, most of which were of pain, and it was considered that two-thirds were suffering from endogenous depression. Bradley (1963) studied thirty-five patients with depression and pain without demonstrable organic cause.…”

Section: Headache With Psychiatric Illnessesmentioning

confidence: 99%

Psychological aspects of headache

Bridges

1971

Postgraduate Medical Journal

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Summary Headache is one of the most common symptoms encountered in clinical practice. Its conceptual problems are those of pain in general and some of the theories concerning pain, especially those attempting to relate psychological and physical aspects, are considered. The classifications which have been suggested for headaches associated with emotional causes are described and it is shown that these are of limited clinical value. Some of the psychogenic causes of headache are considered and the associations of the symptom with various psychiatric illnesses are described. Headache is especially likely to be found with depressive illnesses. The treatments for various psychological types of headache are reviewed.

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“…Whiteley & Denison (1963) have shown that the junior casualty officer in their study saw twice as many new psychiatric patients as the psychiatric out-patient clinic of the hospital in the same period of time. The incidence of psychiatric emergencies is more difficult to assess but Bridges, Koller & Wheeler (1966) found that a psychiatrist was called to the Casualty Department of one hospital to give urgent advice for 0 09% of all new patients seen in the department. However, this was not regarded as a true incidence as it was known that in some psychiatric emergencies where the necessary management was obvious, this was often carried out without specialist help being requested; advice was usually needed more for problems in diagnosis.…”

Section: Incidence Psychiatric Illnessesmentioning

confidence: 99%