Patterns of comorbidity in relation to functioning (GAF) among general hospital psychiatric referrals

Improvement of services for physically ill patients with concurrent psychia tric problems is a noteworthy issue in general hospitals. Among 1249 genera l hospital in-patients referred for psychiatric consultation, concurrent me ntal and behavioural disorders (ICD-10) were diagnosed in 84% of cases. Any concurrent mental and behavioural disorder was associated with dramaticall y low functioning (GAF = 46), indicating serious psychosocial impairment. T his is a striking new finding of clinical importance. The effect on functio ning was similar for substance use disorders, other mental disorders, and c ombined mental and substance use disorders (dual diagnoses), with no gender differences. This finding highlights the need for specialized intervention s among general hospital in-patients referred for psychiatric consultation.