This paper describes the psychiatric consultation-liaison services provided to an Obstetrics and Gynecology Department. Clinical services are provided both by program consultation and by individual inpatient and outpatient referral. Clinical problems in obstetrics and gynecology that result in psychiatric referral are discussed. Research interests which play an important role in the program are described. Educational activities are directed toward ward and clinic staff, undergraduate medical students, residents and the practising specialist. The combination of well articulated consumer requests, interested gynecologists and obstetricians, broadened gynecology residency training objectives, and greater involvement of consultation-liaison psychiatrists suggests a promising future for psychosomatic obstetrics and gynecology.

In the general hospital, consultation-liaison psychiatrists are frequently consulted regarding issues of competency to consent to medical and surgical procedures and treatments. It is necessary that psychiatrists practicing in this setting have a thorough awareness of both the legal aspects of competency and consent and the clinical situations which can arise. In this paper we discuss the legal basis for consent and various definitions proposed for mental competency to consent to treatment. We describe a number of typical situations which lead to psychiatric consultation and suggest an appropriate approach to their resolution.