Abstrakt

Comparison between Psychiatrists and Non-Psychiatric Physicians Identifying Psychiatric Symptoms: A Clinical Study

Abdul Rahman Atram

Background and Objectives: The high prevalence of psychiatric conditions in the general hospital settings and its demand on the system is well known. The aim of this study was to examine the overall diagnostic trends in psychiatric consultations in the city of Zulfi in Riyadh province and to test the ability of non-psychiatric physicians in proper detection of psychiatric morbidity. Subjects and methods: 113 patients were studied in detail over a period of two years. Results: three psychiatric diagnoses were the most prevalent: (1) neurotic, stress related and somatoform disorders (27.6%) (2) Organic, including symptomatic mental disorder (29.2%), and Mood [affective] disorders (15%). There was significantly high agreement between psychiatrists and non- psychiatric physicians in detecting single psychiatric symptomatology (P<0.001),With higher ability to detect negative symptoms (99.1%) conversion (96.5%-) ; and suicide/para suicide (95.6%), but non-psychiatric physicians showed lower ability to detect cognitive, emotional or psychotic symptoms and a significantly lower tendency in detecting the whole range of psychiatric symptoms. Conclusion: Non-psychiatric physicians, sometimes, over-estimate or underestimate the importance of symptom. Because of the high prevalence of organic / cognitive disorders, neurotic and mood disorders in the general medical sitting, Consultation-Liaison teaching should devote most of its energy towards the identification and management of these disorders.