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Clinical Experience With the Management of Schizophrenia in the General Hospital

Received April 8, 2002; revision received July 16, 2002; accepted Aug. 5, 2002. From Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic; and Harvard Medical School, Boston. Address correspondence and reprint requests to Dr. Freudenreich, Massachusetts General Hospital Schizophrenia Program, Freedom Trail Clinic, 25 Staniford St., 2nd Fl., Boston, MA 02114; ofreud{at}massmed.org (e-mail).

On the basis of experience with 74 psychiatric consultations involving patients with schizophrenia admitted to a general hospital medical or surgical ward over a 17-month period (3% of the psychiatric consultations during that period), the authors identified 10 types of problems leading to requests for consultation. The authors used these categories to organize recommendations for management of patients with schizophrenia in the general medical hospital. In addition to conducting conventional consultations, the consultation psychiatrist in such cases often has a role in educating hospital staff about schizophrenia and in serving as a physician for the mentally ill.

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