Dealing with psychological aspects of physical disease

Remember

• Psychiatric morbidity, most commonly depression, anxiety or delirium, is present in 25 to 45% of general hospital patients and in many primary care patients.
• Seeing psychological factors as ‘understandable’ reactions rather than co-manifestations and contributory factors to illness leads to underdetection and poor management.
• Failure of functional recovery in severe and chronic illness may be due to unrecognised and treatable psychiatric and psychological factors.
• Mood and cognition are affected by organic factors related to the disease or physical and pharmacological treatments themselves. Many systemic diseases, HIV, cancer, and cardiac, neurological and endocrine disorders may directly cause depression and anxiety, as may their treatments.