Let's get physical! A study of general practitioner's referral letters to general adult psychiatry--are physical examination and investigation results included?

Scottish Medical Journal
D CulshawK Brown

Abstract

The authors previously conducted a survey of psychiatrists' attitudes to physical examination and investigations of out-patients. The most common reason for not performing such investigations was the expectation that they had already been undertaken by the general practitioner (GP). We decided to test this theory. A series of GP out-patient referral letters to general psychiatry was examined to establish whether findings from physical examination and investigations had been included. One hundred and three letters were examined. None of the letters contained information relating to a physical examination. Only one in twenty had information on investigations despite 4 out of 10 patients in the sample presenting to the GP with somatic symptoms. Details of physical examination and blood tests are not routinely included in referral letters to general psychiatry. This may lead to missed diagnoses of primary or secondary physical illness in psychiatric presentations. Unless it is clearly stated in the GP referral letter, it is unwise to assume that necessary investigations to exclude physical causes of presenting symptoms have been performed. Suggestions are made to improve communication between GPs and psychiatrists.

References

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Citations

Aug 3, 2012·The Journal of Behavioral Health Services & Research·Janet DurbinJosephine McMurray
Mar 5, 2015·European Psychiatry : the Journal of the Association of European Psychiatrists·D BhugraW Gaebel
Oct 27, 2010·World Psychiatry : Official Journal of the World Psychiatric Association (WPA)·Norman SartoriusAllan Tasman
Jan 24, 2021·International Journal of Clinical Practice·Pablo Millares Martin
Aug 22, 2021·European Child & Adolescent Psychiatry·S AydinP M Westenberg

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