Psychiatric 'stretch' in the hospital.

Psychiatric "stretch' in the hospital

A visit to the hospital for medical treatment or surgery is no bed of roses, but chances are the visit will be considerably longer for patients who also have psychiatric disorders.

George Fulop of Mount Sinai School of Medicine in New York City and his colleagues analyzed discharge information on all medical and surgical patients hospitalized in 1984 at Mount Sinai Hospital and at Northwestern Memorial Hospital in Chicago. At both hospitals, the average length of stay of the patients who were also given psychiatric diagnoses was significantly longer than that of the other patients: nearly 20 days versus 9 days at Mount Sinai and almost 14 days versus 8 days at Northwestern Memorial. Psychiatric diagnoses covered a broad spectrum, including organic mental disorder, depression, manic-depression, psychosis, anxiety and substance abuse. Although it has been estimated that 30 to 50 percent of medical and surgical patients have secondary psychiatric disorders, only about 5 percent of the more than 59,000 patients in the study were classed as such.

Comprehensive studies beginning at admission to the hospital are being planned, report the investigators in the July AMERICAN JOURNAL OF PSYCHIATRY. In the meantime, they say that the early identification of medical and surgical patients with psychiatric disorders is critical; some of these patients can be transferred to psychiatric/medical units in the hospital.

Although many psychiatric disorders experienced during medical hospitalization are temporary, they often go undetected, say the researchers. Those that are diagnosed by primary physicians are in many cases undertreated or inappropriately treated.