Recognition of psychiatric disorders in nonpsychiatric hospital wards

Objective: Although many studies have reported that many psychiatric cases are missed by their nonpsychiatric physicians, their methods are often limi ted because ward physicians' recognition has been assessed from potentially unreliable sources such as medical notes. The aim of the present study was to assess recognition by using direct questions to ward physicians. Method s: Five hundred five (505) nonpsychiatric in-patients were interviewed usin g the Clinical Interview Schedule. Ward physicians' recognition of psychiat ric disorders was assessed using a rating form for every patient. Results: The psychiatric prevalence of the total sample was 37.3 %. Overall, ward ph ysicians' diagnostic sensitivity was 54.5%, but their sensitivity varied fo r the different diagnoses (31.3-89.5%). In addition to psychiatric symptoms and abnormalities, intake of psychotropics before admission significantly predicted identification of psychiatric disorders. Conclusions: In our stud y, physicians' sensitivity was higher than that reported from surveys based on medical notes. The fact that nearly half of all psychiatric disorders w ere missed by ward physicians suggests that better psychiatric training for nonpsychiatric doctors is necessary. (C) 2000 Elsevier Science Inc. All ri ghts reserved.