Assessment and management of patients with psychiatric disorders.
OBJECTIVE
To review key issues in the preoperative assessment of patients with psychiatric disorders: assessment of cognitive capacity, psychiatric history, capacity to give informed consent, and the impact of psychotropic medications or substances of abuse. We also outline a general approach to the psychiatric patient. Our review focuses on those psychiatric conditions and medications most likely to complicate perioperative care.


METHODS
Critical studies and expert reviews in the field, as well as the authors' clinical experience in general hospital psychiatry.


CONCLUSIONS
Psychiatric disorders need not unduly complicate perioperative care, but they present certain challenges; a systematic approach as described here will simplify perioperative care of these patients.
Desan
Paul H
PH
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
Powsner
Seth
S
D006801:Humans; D007258:Informed Consent; D008487:Medical History Taking; D016743:Mental Competency; D001523:Mental Disorders / Q000601:surgery*; D009483:Neuropsychological Tests; D010347:Patient Care Planning; D011300:Preoperative Care; D011619:Psychotropic Drugs / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000628:therapy
D011619:Psychotropic Drugs