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For several
reasons, mental health professionals working within a
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mental health
system have a professional and a legal obligation to
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recognize the
presence of physical disease in their patients. First,
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physical
diseases may cause a patient's mental disorder. Second,
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physical disease
may worsen a mental disorder, either by affecting
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brain function
or by giving rise to a psychopathologic reaction. Third,
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mentally ill
patients are often unable or unwilling to seek medical
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care and may
harbor a great deal of undiscovered physical disease.
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Finally, a
patient's visit to a mental health program creates an
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opportunity to
screen for physical disease in a symptomatic
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population. The
yield of disease from such screening is usually
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higher than the
yield in an asymptomatic population. By Lorrin M.
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Koran, M.D.,
Department of Psychiatry and Behavioral Sciences,
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Stanford
University Medical Center Stanford, California 1991
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