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Physical health of patients in rehabilitation and recovery

Michael Phelan, Consultant Psychiatrist

Hammersmith and Fulham Mental Health Unit, Charing Cross Hospital, London W6 8NF

Dr Greening’s survey of the attention paid to physical health parameters of patients in rehabilitation and recovery (Psychiatric Bulletin, June 2005, 29, 210-212) highlighted inadequacies in routine monitoring and a lack of clear guidelines from policymakers over what a full assessment might constitute (National Collaborating Centre for Mental Health, 2003). Standards of competence in physical examination among psychiatric trainees have been widely denigrated and suggestions have been made regarding expected practice (Garden, 2005).

In January 2005 we audited standards of physical healthcare on an acute psychiatric unit and found wide variations in the use of routine blood tests, urinalysis and body mass index (BMI) monitoring. With increasing attention paid to the metabolic effects of schizophrenia and of atypical anti-psychotics (Jin et al, 2004) it was felt that clinicians needed to agree a minimum standard for routine testing of all in-patients. Following discussion of this audit at the unit’s academic meeting, views were assembled over which tests should be regarded as routine. An investigations summary sheet was designed, similar to those used on medical units, and included BMI and prolactin. This allows changes over time to be tracked at a glance and has been added to the admission notes to prompt requests for appropriate tests. The aim is to re-audit these standards in 1 year in anticipation that they will have translated into a more rigorous approach to the physical health of psychiatric in-patients.

References

GARDEN, G. (2005) Physical examination in psychiatric practice. Advances in Psychiatric Treatment, 11, 142 -149.[Abstract/Free Full Text]

JIN, H., MEYER, J. M. & JESTE, D. V. (2004) Atypical antipsychotics and glucose dysregulation: a systematic review. Schizophrenia Research, 71, 195 -212.[CrossRef][Medline]

NATIONAL COLLABORATING CENTRE FOR MENTAL HEALTH (2003) Schizophrenia: Full National Clinical Guideline on Core Interventions in Primary and Secondary Care. London and Leicester: Gaskell and the British Psychological Society.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Pitman, A. Articles by Phelan, M. Search for Related Content PubMed Articles by Pitman, A. Articles by Phelan, M.