General Hospital Psychiatry and Somatisation

Question 1

What are the reasons for increased prevalence of mental health problems in general hospital patients?

Answer 1

Challenges of physical illness
Somatoform disorders
Increased physical morbidity in patients with mental health problems

Question 2

What are the common mental health problems found in general hospital patients?

Answer 2

Affective disorders (depression, anxiety)
Self-harm
Delirium (acute organic confusional state)
Substance misuse disorders
Medically unexplained symptoms (somatoform disorders)
Personality disorders
Dementia
Eating disorders

Question 3

What are the clinical signs of delirium?

Answer 3

Increased/decreased motor activity (hyperactive/hypoactive delirium)
Disorganised thinking, as indicated by rambling, irrelevant or incoherent speech
Perceptual distortions leading to misidentification, illusions or hallucinations
Changes in mood, such as anxiety, depression and lability of mood

Question 4

In what ways might substance misuse/dependance present?

Answer 4

Physical complications 
Intoxications 
Withdrawal 
Trauma/ accident 
Drug- induced psychosis 
Feigned illness in order to obtain drugs

Question 5

In what groups of patients is depression more common?

Answer 5

Chronic illness (renal failure, diabetes, rheumatoid arthritis) 
Neurological diseases (MS, Parkinson's, stroke)

Question 6

What societal group is self harm the most common in?

Answer 6

Females <65 (peak between 19-21)

Question 7

What is the most commonly used drug for overdose?

Answer 7

Paracetamol