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