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ARTICLE |

Patients' Reactions to Psychiatric Consultation FREE

Lorrin M. Koran, MD; John Van Natta, MD; John R. Stephens, MD; Ralph Pascualy, MD
[+] Author Affiliations

Reprint requests to Department of Psychiatry, Stanford University Medical Center, Stanford, CA 94305 (Dr Koran).


JAMA. 1979;241(15):1603-1605. doi:10.1001/jama.1979.03290410035020
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Physicians are often concerned that patients will resent a request for psychiatric consultation. To investigate this problem, 60 patients undergoing psychiatric consultation in a general hospital were interviewed 24 hours after the consultation. Nearly two thirds of these patients believed that the consultation was beneficial. Patients' attitudes were independent of their demographic characteristics, reason for referral, and hospital service involved. Patients with long-term illnesses more often had positive attitudes than patients with short-term illnesses. Patients who were initially hostile or ambivalent usually had positive attitudes 24 hours later. Substance abusers and patients who denied clearly recognizable psychiatric disorders often did not value the consultation. Even so, their physicians frequently believed that the consultation was useful. We attribute the positive attitudes of patients in our study largely to the referring physicians' preparing them for psychiatric consultation.

(JAMA 241:1603-1605, 1979)

REFERENCES

Anstee BH:  The pattern of psychiatric referrals in a general hospital . Br J Psychiatry 120:631-634, 1972;.
Lipowski ZJ:  Review of consultation psychiatry and psychosomatic medicine: II. Clinical aspects . Psychosom Med 29:201-224, 1967;.
Maguire GP, Julier DL, Hawton KE, et al:  Psychiatric morbidity and referral on two general medical wards . Br Med J 1:268-270, 1974;.
Jacobs JW, Bernhard MR, Delgado A, et al:  Screening for organic mental syndromes in the medically ill . Ann Intern Med 86:40-46, 1977;.
Hughson B, Lyons R:  Patient response to psychiatric consultation in a general hospital . Aust NZ J Psychiatry 7:279-282, 1973;.
Hale ML, Abram HS:  Patients' attitudes toward psychiatric consultations in the general hospital . Va Med Mon 94:342-347, 1967;.
Moses R, Barzilay S:  The influence of psychiatric consultation on the course of illness of the general hospital patient . Compr Psychiatry 8:16-26, 1967;.
Schwab JJ, Clemmons RS, Valder BS, et al:  Medical inpatients' reactions to psychiatric consultations . J Nerv Ment Dis 142:215-222, 1966;.
Diagnostic and Statistical Manual of Mental Disorders , ed 2. American Psychiatric Association, Washington, DC, 1968;.
Krakowski AJ:  Liaison psychiatry: Factors influencing the consultation process . Int J Psychiatry Med 4:439-446, 1973;.
Frank JL, Herndon JH:  Psychiatric orthopedic liaison in the management of the amputee war casualty . Int J Psychiatry Med 5:105-114, 1974;.
Mead BT:  Management of hypochondriacal patients . JAMA 192:33-35, 1965;.
Spiro HR:  Chronic factitious illness: Munchausen's syndrome . Arch Gen Psychiatry 18:569-579, 1968;.
Goodwin DW:  Psychiatry and the mysterious medical complaint . JAMA 209:1884-1888, 1969;.
Mendelson M, Meyer M:  Countertransference problems of the liaison psychiatrist . Psychosom Med 23:115-122, 1961;.
Wise TN:  Psychiatric management of patients who threaten to sign out against medical advice . Int J Psychiatry Med 5:153-160, 1974;.
Solow C:  Psychotropic drugs in somatic disorders . Int J Psychiatry Med 6:267-282, 1975;.
Karasu TB, Plutchik R, Conte H, et al:  What do physicians want from a psychiatric consultation service? Compr Psychiatry 18:73-81, 1977;.

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Anstee BH:  The pattern of psychiatric referrals in a general hospital . Br J Psychiatry 120:631-634, 1972;.
Lipowski ZJ:  Review of consultation psychiatry and psychosomatic medicine: II. Clinical aspects . Psychosom Med 29:201-224, 1967;.
Maguire GP, Julier DL, Hawton KE, et al:  Psychiatric morbidity and referral on two general medical wards . Br Med J 1:268-270, 1974;.
Jacobs JW, Bernhard MR, Delgado A, et al:  Screening for organic mental syndromes in the medically ill . Ann Intern Med 86:40-46, 1977;.
Hughson B, Lyons R:  Patient response to psychiatric consultation in a general hospital . Aust NZ J Psychiatry 7:279-282, 1973;.
Hale ML, Abram HS:  Patients' attitudes toward psychiatric consultations in the general hospital . Va Med Mon 94:342-347, 1967;.
Moses R, Barzilay S:  The influence of psychiatric consultation on the course of illness of the general hospital patient . Compr Psychiatry 8:16-26, 1967;.
Schwab JJ, Clemmons RS, Valder BS, et al:  Medical inpatients' reactions to psychiatric consultations . J Nerv Ment Dis 142:215-222, 1966;.
Diagnostic and Statistical Manual of Mental Disorders , ed 2. American Psychiatric Association, Washington, DC, 1968;.
Krakowski AJ:  Liaison psychiatry: Factors influencing the consultation process . Int J Psychiatry Med 4:439-446, 1973;.
Frank JL, Herndon JH:  Psychiatric orthopedic liaison in the management of the amputee war casualty . Int J Psychiatry Med 5:105-114, 1974;.
Mead BT:  Management of hypochondriacal patients . JAMA 192:33-35, 1965;.
Spiro HR:  Chronic factitious illness: Munchausen's syndrome . Arch Gen Psychiatry 18:569-579, 1968;.
Goodwin DW:  Psychiatry and the mysterious medical complaint . JAMA 209:1884-1888, 1969;.
Mendelson M, Meyer M:  Countertransference problems of the liaison psychiatrist . Psychosom Med 23:115-122, 1961;.
Wise TN:  Psychiatric management of patients who threaten to sign out against medical advice . Int J Psychiatry Med 5:153-160, 1974;.
Solow C:  Psychotropic drugs in somatic disorders . Int J Psychiatry Med 6:267-282, 1975;.
Karasu TB, Plutchik R, Conte H, et al:  What do physicians want from a psychiatric consultation service? Compr Psychiatry 18:73-81, 1977;.
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