title: Change in accuracy of recognizing psychiatric disorders by non-psychiatric physicians: five-year data from a psychiatric consultation-liaison service.
abstract: OBJECTIVE
  Psychiatric disorders are easily underestimated and under-recognized by physicians. The aim of the present study was to investigate the change in accuracy of recognizing psychiatric symptoms.
  
  
  METHODS
  Consecutive 5-year consultation-liaison data were collected and patients with one of the five common psychiatric diagnoses, including depressive disorders, substance use disorders, delirium, anxiety disorders and psychotic disorders, were chosen for analysis. The primary care physician's initial impression of a psychiatric diagnosis was recorded based on their reason for referral on the referral sheets. Accurate recognition was defined as matching of the physician's initial impression with the psychiatrist's final diagnosis. Mentioning the core symptoms of psychiatric diagnostic criteria or common synonyms would be considered as correct recognition.
  
  
  RESULTS
  The overall accuracy of recognition was 41.5% and there was no significant change during this 5-year period. Substance use disorders were the one diagnosis with the highest agreement, followed by delirium, depressive disorders, anxiety disorders, and psychotic disorders. As for the factors associated with accurate recognition, male patients or those with multiple physical illnesses were more likely to have their psychiatric symptoms recognized correctly.
  
  
  CONCLUSIONS
  Without comprehensive postgraduate psychiatric education, the accuracy of recognizing psychiatric symptoms does not improve year by year. Education should focus on common psychiatric problems among medical inpatients, especially those easily misdiagnosed, such as depression and delirium.
authors.affiliation: Department of Psychiatry, Chang Gung Memorial Hospital at Chiayi, Taiwan.
authors.forename: Jian-An
authors.initials: JA
authors.lastname: Su
authors.forename: Ching-Shu
authors.initials: CS
authors.lastname: Tsai
authors.forename: Tai-Hsin
authors.initials: TH
authors.lastname: Hung
authors.forename: Shih-Yong
authors.initials: SY
authors.lastname: Chou
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003693:Delirium / Q000175:diagnosis; D003866:Depressive Disorder / Q000175:diagnosis; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D019263:Dysthymic Disorder / Q000175:diagnosis; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006769:Hospitals, General; D006801:Humans; D007297:Inpatients / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D011618:Psychotic Disorders / Q000175:diagnosis; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000175:diagnosis