The Section of Psychiatry and Medicine provides care for up to 10 to 15 percent of all patients admitted to medical, surgical, neurological, obstetrical and gynecological services.
Depression, Anxiety and Cognitive Problems Are Common
Approximately 30 percent of all hospitalized medical, surgical, neurological, obstetrical and gynecologic patients have evidence of symptoms of anxiety or depression. Between 30 to 60 percent of critically ill medical or surgical inpatients, particularly those in intensive care settings, will present with cognitive and behavioral difficulties secondary to their illness or the treatment for their illness.
Treatment of These Disorders
Prevents Medical Morbidity and Mortality
In addition to interfering with the patient’s quality of life, these problems can increase medical morbidity and mortality, so therefore, effective treatment is essential.
Management of these patients may include assessment of treatable medical conditions which might result in depression, anxiety or cognitive problems, particularly in the elderly. This is of special importance when the cognitive problems caused by a delirium results in a disturbance in the patient’s attention, behavior and ability to participate in their medical care. Some patients are assisted by medications that will improve depression, anxiety and delirium. Providing specialized supportive care in collaboration with nursing and other health care providers is essential.
Compassionate understanding of the ill patients experience is a prerequisite to assisting the patients and their families to deal with hospitalization and illness. Most patients seen through our service have never had previous psychiatric care. This treatment and improvement of the patient’s medical status can be expected to return the patient to their previous baseline level of psychological functioning.
Cancer, Pain, Transplantation, Geriatrics
The section also provides care for patients dealing with cancer, end of life issues, chronic pain, organ and stem cell transplantation. Particular attention is given to the special problems of geriatric patients. The service also assists in the determination of decisional capacity, which is often affected by medical illness in geriatric patients. We provide diagnostic and treatment recommendations for medical symptoms that cannot be explained by the initial medical evaluation.
The Section of Psychiatry and Medicine also provides specialized care for patients who are pregnant or who are post partum. The rate of peripartum depression and other emotional disorders in pregnant and post-partum patients is 15 percent.
Care for Those With Existing Health Issues
Approximately 10 percent of patients seen by the Section of Psychiatry and Medicine have had previous mental health problems. For these patients, the section assists in the management of their psychotropic medications and provides supportive emotional care to help them through their medical, surgical, neurological, obstetrical or gynecological hospitalization.
We also provide care for patients on non-psychiatric services with alcohol and substance use disorders and those with suicidal thoughts or those who have attempted to commit suicide and require medical hospitalization.
When necessary, the service also assists with planning follow-up inpatient and outpatient psychiatric care after discharge from these non-psychiatric services.
The ongoing focus of the Section of Psychiatry and Medicine is to provide innovative, quality improvement in our services through research and evidence-based data and to implement these improvements through the electronic medical records used at Rush University Medical Center.