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 limited 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.


METHODS
Five hundred five (505) nonpsychiatric in-patients were interviewed using the Clinical Interview Schedule. Ward physicians' recognition of psychiatric disorders was assessed using a rating form for every patient.


RESULTS
The psychiatric prevalence of the total sample was 37.3%. Overall, ward physicians' diagnostic sensitivity was 54.5%, but their sensitivity varied for 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 study, physicians' sensitivity was higher than that reported from surveys based on medical notes. The fact that nearly half of all psychiatric disorders were missed by ward physicians suggests that better psychiatric training for nonpsychiatric doctors is necessary.
Wancata
J
J
Department of Psychiatry, University of Vienna, Währinger Gürtel 18-20, A-1090, Vienna, Austria. johannes.wancata@akh-wien.ac.at
Windhaber
J
J
Bach
M
M
Meise
U
U
D000368:Aged; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004501:Education, Medical / Q000592:standards; D005194:Family Practice; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011570:Psychiatry / Q000193:education; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013001:Somatoform Disorders / Q000523:psychology