title: Medical and psychiatric comorbidity in psychiatric beds in general hospitals: a cross-sectional study in Tokyo.
abstract: OBJECTIVE
  Although somatic diseases in psychiatric patients are increasing with the increase of the aged population, psychiatric wards in general hospitals in Japan have progressively been decreasing. The purpose of this cross-sectional study was to clarify whether psychiatric beds in general hospitals play sufficient roles in medical comorbidities of psychiatric patients or not.
  
  
  METHODS
  This was a cross-sectional study performed all over Tokyo during the 2-month period from April to May 2007. The total number of patients who require admission due to both somatic and psychiatric diseases was investigated with their demographic and clinical characteristics.
  
  
  RESULTS
  The total number of patients admitted to psychiatric beds in general hospitals for the above-mentioned reason was 326, while the number of patients who could not be admitted to them despite the same reason was 88. The rate of surgical diseases in the latter group was higher than that in the former group. In the latter group, diseases requiring orthopedic surgery (22%) and abdominal surgery (22%) were the most frequent, followed by gastrointestinal and hepatic diseases (8%), and gynecological diseases (7%). Patients who had attempted suicide were included more in the latter group than in the former group. Even in the former group, general hospitals could not respond to 34% of requests for emergency admission.
  
  
  CONCLUSIONS
  Psychiatric beds in general hospitals do not necessarily function for medical comorbidities in psychiatric patients, especially in severe and emergency cases. Not only the quantity but also the quality of psychiatric wards in general hospitals should be reconsidered.
authors: Department of Psychiatry, Juntendo University School of Medicine, Tokyo, Japan. khatta@juntendo.ac.jp
authors: Kotaro
authors: K
authors: Hatta
authors: Hiroyuki
authors: H
authors: Nakamura
authors: Chie
authors: C
authors: Usui
authors: Takafumi
authors: T
authors: Kobayashi
authors: Yoshito
authors: Y
authors: Kamijo
authors: Toyoaki
authors: T
authors: Hirata
authors: Shuichi
authors: S
authors: Awata
authors: Yasuhiro
authors: Y
authors: Kishi
authors: Heii
authors: H
authors: Arai
authors: Hisashi
authors: H
authors: Kurosawa
mesh_terms: D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000453:epidemiology*; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D014041:Tokyo