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Psychiatric Screening of Admissions to an Accident and Emergency Ward

Published online by Cambridge University Press:  03 January 2018

Gary Bell ,
Dan Z. Reinstein ,
Gitendra Rajiyah  and
Rachel Rosser
Gary Bell*
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
Dan Z. Reinstein
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
Gitendra Rajiyah
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
Rachel Rosser
Affiliation:
Department of Psychiatry, University College and Middlesex School of Medicine, University College London, Middlesex Hospital, London W1N 8AA
*
∗Senior Lecturer, Department of Psychological Medicine, Medical College of St Bartholomew's Hospital, West Smithfield, London EC1A 7BE
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Abstract

One hundred medical and surgical patients admitted to an accident and emergency ward were screened for psychiatric disorder. A psychiatric diagnosis was made in 37 patients, 32 of whom were correctly identified by the GHQ. Psychiatric morbidity was associated with being single, lower social class, unemployment, homelessness and living in Bloomsbury Health District or north-east London. It was also associated with not being registered with a GP. The 14 overdose patients were no more likely to receive a psychiatric diagnosis than other patients, yet constituted most of the psychiatric referrals. Few patients were asked by medical staff about emotional worries or problems. A desire to be asked such questions and a past psychiatric history were associated with a psychiatric diagnosis. Routine screening of psychiatric morbidity in both medical and surgical patients and appropriate psychiatric referral of identified patients is recommended. A system of facilitating GP registration is necessary, as much of the morbidity identified could be contained within primary care.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 158 , Issue 4 , April 1991 , pp. 554 - 557
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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