Page 23 - Complementary and Alternative Medicine Treatments in Psychiatry

The Comprehensive Medical Exam in Psychiatry | 23

a Danish study of cancer rates in first-time psychiatric patients,
lead author Michael E. Benros remarked, “The overall cancer
incidence was highest in persons older than 50 years of age
admitted with a first-time mood disorder, where 1 out of 54
patients would have a malignant cancer diagnosed within the
first year.” The overall incidence of cancer was increased almost
4-fold and the incidence of brain tumors was increased 37 times.
He concluded: “Our study illustrates the importance of making a
thorough physical examination of patients with first-time
psychiatric symptoms.” (Benros 2009) (Nelson 2009)
Despite the commonality of psychiatric symptoms that are
created by non-psychiatric medical disorders, the subject is
rarely given the vigilance it deserves. A text on the topic did not
even exist in the Americas until 1967 when Dr. Sydney Walker
wrote Psychiatric Signs and Symptoms Due to Medical Problems
(Walker 1967). A survey carried out in 2001 by the nonprofit Safe
Harbor (of which the author is president) found that the 100,000
outpatients seen annually by the Los Angeles County Department
of Mental Health were routinely not given medical exams.
One reason for this oversight is because diagnoses such as
schizophrenia, bipolar disorder, and even major depression are
often thought of as discrete disease entities, when in fact, they
are not. They are syndromes of generally unknown etiology.
Because the causes of these syndromes have evaded
investigators for centuries, there is a tendency to consider the
etiology as unknowable, when, through a thorough medical
exam and differential diagnosis, the possibility exists that the
causes of even the worst psychiatric manifestations may be
determined and may even be completely treatable.
Further, it has become customary to treat psychiatric
symptoms pharmaceutically, without considering the cause.
Additionally, once a patient has been labeled with a psychiatric
disorder, there is a tendency on the part of doctors and hospital
staff to not look further. Lastly, a psychiatric patient may be
unable or unmotivated to voice physical complaints.