Document Detail


Unrecognized physical illness prompting psychiatric admission.
MedLine Citation:
PMID:  20680191     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We assessed factors that might contribute to clinicians erroneously attributing medically based changes in a patient's mental status to psychiatric illness.
METHODS: Records of 1340 patients admitted to a VA hospital psychiatric unit and 613 to a public hospital psychiatric unit from 2001 to 2007 were reviewed. Cases admitted because of an unrecognized medical disorder underwent further analysis of the preadmission assessment and documented history of mental illness.
RESULTS: Of 1340 patients whose records were reviewed, 55 (2.8%) had a medical disorder that caused their symptoms. Compared with patients admitted to medical units, patients inappropriately admitted to psychiatric units had lower rates of completion of medical histories, physical examinations, cognitive assessments, indicated laboratory and/or radiologic studies, and treatment of abnormal vital signs (P < .001 in each case). Among patients admitted to psychiatric units, 85.5% had a history of mental illness vs 30.9% of comparable admissions to medical units (Chi2(1) = 35.85; P < .001).
CONCLUSIONS: Key assessment procedures are less likely to be performed in patients with mental status changes who are admitted to psychiatric units than in comparable patients admitted to medical units. Symptoms of patients with a history of mental illness are more likely to be attributed to psychiatric illness than are those of patients without such a history.
Authors:
Roy R Reeves; Jefferson D Parker; Peggy Loveless; Randy S Burke; Roy H Hart
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists     Volume:  22     ISSN:  1547-3325     ISO Abbreviation:  Ann Clin Psychiatry     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2011-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911021     Medline TA:  Ann Clin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-5     Citation Subset:  IM    
Affiliation:
University of Mississippi School of Medicine, G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS 39216 USA. roy.reeves@va.gov
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Comorbidity
Delayed Diagnosis
Delirium, Dementia, Amnestic, Cognitive Disorders / diagnosis*,  epidemiology,  etiology,  psychology
Diagnostic Errors* / psychology,  statistics & numerical data
Female
Hospitals, Veterans
Humans
Male
Medical History Taking
Mental Disorders / diagnosis,  epidemiology,  psychology
Mental Status Schedule
Middle Aged
Mississippi
Patient Admission*
Psychiatric Department, Hospital*
Referral and Consultation / statistics & numerical data
Retrospective Studies
Substance-Related Disorders / diagnosis,  epidemiology,  etiology,  psychology
Young Adult

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