From psychosomatic medicine to consultation-liaison psychiatry. 1993

G C Smith
Department of Psychological Medicine, Monash University, Monash Medical Centre, Clayton, Vic.

OBJECTIVE To trace the movement from psychosomatic medicine to consultation-liaison psychiatry, the forces at work in shaping the change, and the extent to which the change is reflected in the latest revisions of the International classification of diseases (ICD-10) and the Diagnostic and statistical manual of mental disorders, third revision (DSM-III-R). METHODS Identification of important trends in the field was aided by discussions with fellow members of the panel of compilers of the consultation-liaison psychiatry literature review expert list published bi-annually in General Hospital Psychiatry. The expert list is based on appropriate literature searches. RESULTS Psychosomatic medicine continues as a science, studying the relationships between biological, psychological and social phenomena in health and disease. The main advocates of the clinical application of the concepts and findings of psychosomatic medicine are now the general hospital consultation-liaison psychiatrists and their allied health professional colleagues. The mainstreaming of psychiatry into medicine has accentuated the role of the consultation-liaison psychiatrist. In attempting to translate the advances in the field into a new taxonomy, both ICD-10 and DSM-III-R have created a new language that hinders understanding by a medical profession perhaps now less prone to resistance to holism. CONCLUSIONS There is a need for a valid taxonomy that addresses the most common form of psychiatric presentation in the community, that of physical/psychiatric co-morbidity, and for outcome studies based on such a taxonomy. Consultation-liaison psychiatrists need to educate their colleagues about the changes in concepts and terminology.

UI MeSH Term Description Entries
D011570 Psychiatry The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders.
D011611 Psychosomatic Medicine A system of medicine which aims at discovering the exact nature of the relationship between the emotions and bodily function, affirming the principle that the mind and body are one. Medicine, Psychosomatic
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D006694 Holistic Health Health as viewed from the perspective that humans function as complete, integrated units rather than as aggregates of separate parts. Holistic Medicine,Holistic Therapies,Medicine, Holistic,Whole Person Health,Wholistic Health,Medicine, Wholistic,Wholistic Health Care,Wholistic Medicine,Wholistic Therapies,Care, Wholistic Health,Health Care, Wholistic,Health, Holistic,Health, Whole Person,Health, Wholistic,Holistic Therapy,Person Health, Whole,Therapies, Holistic,Therapies, Wholistic,Therapy, Holistic,Therapy, Wholistic,Wholistic Therapy
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001523 Mental Disorders Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. Mental Illness,Psychiatric Diseases,Psychiatric Disorders,Psychiatric Illness,Behavior Disorders,Diagnosis, Psychiatric,Mental Disorders, Severe,Psychiatric Diagnosis,Illness, Mental,Mental Disorder,Mental Disorder, Severe,Mental Illnesses,Psychiatric Disease,Psychiatric Disorder,Psychiatric Illnesses,Severe Mental Disorder,Severe Mental Disorders

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