While the evolving managed care revolution is dramatically changing the clinical, educational, and economic systems in which consultation-liaison (C-L) psychiatrists must operate, this revolution also present several important opportunities for those in C-L psychiatry. The authors, who are academic department chairs and formerly directed C-L divisions, discuss C-L psychiatry's potential involvement and suggest approaches to effectively address key aspects of these changes.

Forecasting↗

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Psychopathology in medical inpatients and its relationship to length of hospital stay: a pilot study.

A composite screening instrument measuring depression, anxiety, cognitive dysfunction, and pain identified 40 percent of a sample of general medical inpatients (30% of total patients before exclusions) as having significant psychopathology or pain, a reasonable number based on clinical incidence literature. These identified patients' hospital length of stay did not differ from the length of stay for other patients. The screen identified 21 percent as very depressed, 19 percent as very anxious, 15 percent as having cognitive dysfunction, and 11 percent with high pain levels. Depression, anxiety, and pain frequently occurred together. Further study is required to refine the instrument and assess its effectiveness at targeting patients for psychiatric intervention.

Anxiety Disorders↗

PubMedDate not supplied

The validity of psychiatric diagnosis under conditions of physical trauma: a pilot study.

The validity of psychiatric diagnosis obtained from hospitalized trauma patients was investigated to determine whether hospitalization with associated pain, discomfort, and medication artificially inflated the estimated prevalence of psychiatric diagnoses. Diagnostic Interview Schedule results from eleven hospitalized patients were compared with those obtained from the same patients after discharge. Diagnoses were found to be consistent for eight of eleven patients and eleven of fifteen diagnoses remained unchanged. This study yielded no evidence that recent trauma and hospitalization significantly influenced the initial psychiatric diagnoses obtained using the DIS.