REASONS FOR MEDICAL CONSULTATION IN PSYCH IATRIC-PATIENTS - SOMATIZATION AND SUICIDAL ATTEMPTS

BACKGROUND: The objectives of the study are to document the frequency of use of the general medical services by psychiatric patients, to mea sure how many consultations are due to somatization and suicide attemp ts and to know the existence by possible differences between psychiatr ic inpatients and outpatients in relation to the reason of medical con sultation. MATERIAL AND METHODS: Design: retrospective study. Site: Ma nchester Royal Infirmary, a university third level hospital in Manches ter (United Kingdom). Patients: patients from the psychiatric departme nt seen during the period from July Ist to December 31th in 1992 (n = 1,012 patients). RESULTS: The Percentage of patients that consults a m edical/surgical department in one year is 27.5%, 25.2% of outpatients and 36.3% of inpatients. Non-medical reasons are 42.3% of these consul tations: 30.4% somatization phenomena and 10.8% suicide attempts. The frequency of somatization in psychiatric patients (30.4%) is similar t o that described in nonpsychiatric patients. The psychiatric inpatient s that are referred to a medical department as inpatients show a signi ficant lower rate of somatization (2.2%) and a higher rate of suicide (35.5%). CONCLUSIONS: One fourth of psychiatric patients consult a med ical department in one year and more than 40% of these consultations a re not due to somatic diseases. The frequency of somatization in psych iatric patients is similar to the observed in other patients. Psychiat ric inpatients that are also medical inpatients in one year constitute a specific high risk group.