From the Editor

In my last hospital job, an afternoon might involve seeing a gentleman with poorly controlled diabetes, a woman who wasn’t participating in her post-hip physiotherapy, and an ICU patient with multiple problems. The common thread: they all had psychiatric diagnoses (PTSD, depression, and delirium, respectively).

Patients with physical and mental health problems can be costly and complicated. They also pose a challenge for a health care system that is designed for the simplicity of tackling one problem at a time.

This week, we look at a couple of papers on this interface between mental and physical health.

In the first paper, the University of Rochester’s Mark A. Oldman and his co-authors wonder if proactive psychiatric consultations can reduce hospital length of stay. With a systematic review, they conclude: “Our review indicates that proactive models of CL psychiatry whose screening is enriched by clinical expertise in mental health care and that deliver enhanced, proactive mental health services appear to reduce LOS, with preliminary cost-benefit analyses reporting favorable returns on investment that more than offset the increased costs of providing this level of enhanced care.”

hospitalGood Hospital, Good CL Service?

In the second paper, the University of Toronto’s Matthew J. Burke, a neurologist, considers patients who present with symptoms unexplained by medical disease. “The irony of ‘it’s all in your head’ is that although this phrase is often used inappropriately and dismissively, it is technically correct.”

DG

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