15. General Hospital Psychiatry & Somatisation

Question 1

Why are Mental Health Problems in General Hospital Patients not Always Recognised?

Answer 1

1. May be Disguised as a Physical Disorder
2. Focus on Physical Disorder - Mental Symptoms not Inquired about
3. Reaction considered to be normal

Question 2

What are the Reasons for Increased Prevalence of Mental Health Problems in the General Hospital?

Answer 2

1. Challenges of Physical Illness
2. a) Psychological (including Treatment)
3. b) Effect of Physical Illness of Brain Functioning
4. c) Treatment of Physical Illness - e.g. Medication
5. Increased Physical Morbidity in Patients with this
6. Somatoform Disorders - Medically Unexplained Symptoms

Question 3

What are the common Mental Health Problems in the General Hospital?

Answer 3

1. Affective Disorders - Depression / Anxiety
2. Substance Misuse Disorders / Self-Harm
3. Organic Mental Disorders - Delirium / Dementia
4. Personality Disorders
5. Eating Disorders
6. Somatoform Disorders - Medically Unexplained Symptoms

Question 4

What are the Uncommon Mental Health Problems in the General Hospital?

Answer 4

1. Schizophrenia
2. Bipolar Affective Disorder
3. Severe Depression

Question 5

Who is Depression common in, in the General Hospital Setting?

Answer 5

Chronic Illness - In particular Neurological Diseases

Question 6

Who is most likely to be Admitted with Self-Harm?

Answer 6

Women > 65 years old

Question 7

How might Substance Misuse present?

Answer 7

1. Physical Complications
2. Intoxication
3. Withdrawal
4. Trauma / Accident
5. Drug-Induced Psychosis
6. Feigned Illness in order to Obtain Drugs