Psychological care of medical patients: a practical guide

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Please note: this report has been withdrawn and is not for clinical use.

A joint report of the Royal College of Physicians and the Royal College of Psychiatrists, published January 2003 

Most hospital doctors recognise that many patients suffering from physical illness also experience psychological distress that requires intervention. Medical staff also have to treat large numbers of patients following deliberate self-harm or with complications of alcohol and drug misuse, and those with medically unexplained symptoms. However, they do not always feel adequately equipped to meet the different psychological needs of these groups.

This practical guide will enable hospital clinicians to identify patients with significant psychological problems, and to distinguish between those who need to be referred for specialist psychiatric or psychological assessment, and those they can treat themselves.

The various treatment options available to the clinician are reviewed, using the most up-to-date research findings. The report pays particular attention to the need for sensitive communication skills, which underpin all effective psychological assessment and intervention.

Liaison psychiatry services are gradually being developed in general hospitals but they are often rudimentary and restricted to the treatment of patients who deliberately self-harm. The report argues persuasively for the establishment of multidisciplinary liaison psychiatry teams in every general hospital, and for a strong psychological component in hospital development so that medical staff are able to develop the psychological skills they need to assess and manage patients' problems.

This report, which is available to download as a pdf, will be an invaluable guide not only for physicians but also for clinical psychologists, nurses, managers and other health professionals who work with medical patients in general hospitals.


  • Introduction
  • Communication and psychological assessment
  • Psychological responses to illness
  • Medically unexplained symptoms
  • Management of psychological problems
  • Deliberate self-harm
  • Alcohol and drug misuse
  • Dementia, delirium and organic mood disorders
  • The Mental Health Act 1983, common law and consent to treatment
  • Developing a liaison service

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