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BackgroundPsychiatric comorbidities are common among patients treated for physical disorders. Attitudes of non-psychiatric doctors toward psychological/psychiatric problems have significant implications for care provision in the general hospital setting. Our objective was to investigate non-psychiatric doctors’ attitudes in China.MethodAn anonymous online questionnaire pertaining to relevant attitudes was distributed to Chinese hospital-based non-psychiatric doctors using a mobile App.ResultsA total of 306 non-psychiatric doctors in China voluntarily completed the questionnaire. All but two (99.3%) respondents agreed with the importance of psychological factors underlying physical illness and 85.6% agreed they had a high degree of responsibility for management of patients’ emotional problems. Most respondents endorsed routine assessment of patients’ psychological factors and were willing to consider psychiatric referrals for patients in need; despite 52.0% believing that mental health care by general hospital doctors was impractical. Almost all respondents welcomed more contact with psychiatric services and indicated a need for more time and professional help to manage psychological issues. Respondents’ demographic characteristics and vocational status had some influence on attitudes; female doctors were more likely and surgeons less likely to consider psychological assessment and emotional care for patients with physical illness. More doctors working in hospitals with established consultation-liaison psychiatric services did not feel responsible for their patients’ emotional care (17.7% vs. 6.6%, P = 0.012).ConclusionsOur pilot survey demonstrates a potential generally positive attitude toward management of patients’ psychological problems and an urgent need for more time and specialist support for non-psychiatric doctors in China.

ObjectivePsychiatric comorbidities are common in physical illness and significantly affect health outcomes. Attitudes of general hospital doctors toward psychiatry are important as they influence referral patterns and quality of care. Little is known about these attitudes and their cultural correlates. The aim of this study was to identify attitudes toward psychiatry among general hospital specialists in relation to culture of the practice setting and other clinician factors (gender, age, seniority and specialty).MethodsA cross-sectional, descriptive study was carried out in seven countries (New Zealand, China, Sri Lanka, Russia, Israel, Brazil, the Netherlands). Data were collected from senior medical staff of various disciplines using an updated version of Mayou and Smith’s (1986) self-administered questionnaire.ResultsA total of 889 hospital doctors participated. While favourable attitudes toward both psychiatric consultation and management were endorsed by a majority, significant differences were also observed between countries. Subgroup differences were mostly confined to gender, acuity of practice setting and specialty. For example, female doctors in Russia (χ2=7.7, p=0.0056), China (χ2=9.2, p=0.0025) and the Netherlands (χ2=5.7, p=0.0174) endorsed more positive attitudes compared with their male counterparts, but this gender effect was not replicated in the total sample. Chronic care specialists were overall more inclined to manage patients’ emotional problems compared with those working in acute care (χ2=70.8, p (adjusted)<0.0001), a significant finding seen also in individual countries (China, New Zealand, the Netherlands, Russia). Physicians were more favourably disposed toward psychiatry compared with other specialists, especially surgeons, in all countries except Israel.ConclusionsThis study adds to evidence for the association of medical attitudes with individual clinician factors and demonstrates that the influence of these factors varies by country. Understanding these issues may help to overcome barriers and improve quality of care provided to general hospital patients.

Background:Acute behavioural disturbance in psychiatric patients often requires urgent treatment. National guidelines in England indicate that olanzapine is a suitable alternative to older antipsychotics due to a beneficial side effect profile.Method:A retrospective study that looked at the case notes of 32 patients on an acute adult and psychogeriatric ward. Information was gathered on patient gender, diagnosis, incidence of acute behavioural disturbance in the preceding 3 months and the type of medication and route of administration chosen.Results:Of the patients assessed 56.2% (18/32) were male and 43,8% (14/32) were female.62.5% (20/32) were aged between 18-65 years and 37.5% (12/32) were aged over 65yrs.43.8% (14/32) had a diagnosis of schizophrenia and 21.9% (7/32) had a diagnosis of bipolar affective disorder.Pharmacological intervention for acutely disturbed behaviour was necessary in 46.9%(15/32) of patients. In 86.6% (13/15) of these cases the oral route of administration was chosen. Haloperidol was used in 46.6%(7/15) of cases while the other cases necessitated the use of lorazepam only. Although oral and im preparations of olanzapine were available neither were chosen in any of the above cases. Vital signs were monitored in only 6.6% (1/15).Conclusions:Surprisingly haloperidol, an older antipsychotic, is still preferred over olanzapine which has fewer extrapyramidal side effects and is widely acknowledged to be effective in the acute setting.