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Psychiatric Referrals within the General Hospital: Comparison with Referrals to General Practitioners

Published online by Cambridge University Press:  02 January 2018

Francis Creed*
Affiliation:
Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL
Elspeth Guthrie
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary
Dawn Black
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary, now Consultant Psychiatrist, Hope Hospital, Salford
Mark Tranmer
Affiliation:
Department of Psychiatry, Manchester Royal Infirmary
*
Correspondence

Abstract

The increase in referrals to a new consultant psychiatrist within a teaching hospital was documented. During 1987/88 there were 279 consecutive referrals from physicians and surgeons (159 out-patients and 120 ward-consultation requests) which were compared with 184 consecutive GP referrals over the same period. Hospital referrals tended to be older, and less socially disadvantaged, but with psychiatric disorder of similar severity to GP referrals. They were more likely to have a concurrent physical diagnosis, and demonstrate somatisation. The latter was not confined to patients without physical disorder; half of the patients classified as ‘psychological reaction to physical disorder’ showed somatisation. ICD–10 appeared to perform better than ICD–9 or DSM–III for somatoform disorders, but a comprehensive classification system is still needed for liaison psychiatry. Personal discussion with the referring doctor was most common among the ward-consultation requests; in this situation the referring doctor usually continued primary management of the patient.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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