Medical conditions associated with psychiatric disorder 

Seven out of 10 office visits to a primary care practitioner are related to a chronic illness. There are high levels of association of many of these chronic conditions with psychiatric disorders. Comorbid medical and psychiatric conditions increase use of medical resources and costs, as well as amplify functional impairment. For example, depression is associated with an approximately 50 per cent increase in medical costs of chronic medical illness, even after controlling for severity of physical illness. Dementia is associated with hospital costs up to 75 per cent higher than for non-demented patients. As important as a comprehensive knowledge of psychiatric diagnosis and psychosocial formulation is to a consulting psychiatrist, it is also vital to understand the pathophysiology and clinical characteristics of the medical and surgical conditions that frequently coexist with psychiatric disorders. It is also important to know the behavioural and psychiatric side effects of medications and substances. Lacking this data permits only a partial and inadequate approach to diagnosis and treatment. This section describes general medical disorders associated with psychiatric syndromes. The pathophysiology and clinical characteristics of the medical disorder are described first, followed by psychiatric syndromes often seen with that diagnosis.