Physical Illness and Psychiatric Disorder

Abstract

During the past decade investigators have paid increasing attention to the association between physical illness and psychiatric disorders.¹ Several factors seem to have contributed to this welcome development. First, rapid development of consultation-liaison psychiatry has brought psychiatrists closer to the physically ill on a scale never known before. As a result, the types and frequency of psychiatric disorders in this patient population have come into focus and become a subject of a growing number of studies. Their aim has been to obtain data that could serve as a basis for estimating the extent of need for psychiatric services in the general hospitals and other medical health care facilities. Second, demographic trends in the Western countries and elsewhere have drawn attention to the growing number of the elderly, those aged 65 years and over, among whom the prevalence and incidence of both physical and psychiatric morbidity are high, and the two types of morbidity are frequently concurrent. In order to plan adequate health facilities for the elderly, it is important to establish how often psychiatric disorder complicates physical illness among them, which of these disorders are especially common, and what role the physical illness appears to play in their occurrence. Such information could lead to more effective prevention of psychiatric morbidity in the physically ill elderly patients. Third, the prevalence of chronic systemic diseases, cardiovascular, respiratory, neoplastic, musculoskeletal, and neurological, is high and may be expected to rise as the number of very old persons predictably increases in the coming decades. It is clearly important to have data about the frequency, types, and severity of psychiatric disorders in patients suffering from these diseases, as a basis for planning preventive and therapeutic measures. And fourth, medical progress has brought in its wake a host of psychiatric problems resulting from the side effects of new medical drugs and from such procedures as chronic renal hemodialyis, open-heart surgery, and intensive care. Psychiatric complications arising from these medical and surgical treatments increase the burden of illness for the patients and adversely affect their quality of life. To plan adequate psychiatric services as well as effective preventive and therapeutic measures it is necessary to collect data about the frequency and types of psychiatric disorders resulting from various forms of medical and surgical treatments.