Do psychiatrists perform appropriate physical investigations for their patients? A review of current practices in a general psychiatric inpatient and outpatient setting

Background: Mental disorder and physical health are intimately linked. However, research indicates that psychiatrists are often unclear about their role in caring for the physical health of their patients. Aims and Method: This study aimed to find out whether psychiatrists perform appropriate physical examinations and investigations for their patients. To investigate this, a case-note review was conducted of 50 newly referred consecutive adult inpatients and 50 newly referred consecutive adult outpatients. Results: 80% of the inpatients had routine haematological investigations performed compared with 6% of the outpatients. 62% of the inpatients had a full physical examination compared with 0% of the outpatient group. Overall the level of record keeping was poor, in particular where physical examinations or investigations were omitted. Clinical implications: This study showed a poor level of consideration of basic physical examinations and investigations for psychiatric patients, particularly in the outpatient setting. Psychiatrists have a duty to ensure that the basic healthcare needs of their patients are met and should not assume that this is the sole responsibility of the general practitioner.