The role of the psychiatrist in the general hospital. I. Investigation and analysis pertaining the status of the psychiatrist in the general hospital.

Data for this study consisted of answers to a series of questions on the image of clinical psychiatry addressed to all the non-ppsychiatric clinicians in the Tokai University Hospital, and all the referral sheets for psychiatric consultation from non-psychiatric departments of the hospital for about 2 years since the beginning of the hospital's operation. The reaction was analysed as follows: (1) psychiatric services were requested for the reasons of "no organic abnormality" or for "differential diagnosis" in 59.4% of total referrals, (2) as many as 37.9% of non-psychiatric clinicians made no attempt to refer the patient to psychiatrists in spite of their recognition that these patients apparently needed psychiatric treatment, (3) trouble in doctor-patient relationship, if it was the real reason for asking for sychiatric services, was frequently not mentioned in the referral sheet, and (4) the reason for psychiatric consultation was rarely told clearly to the patient. On the basis of the above-mentioned findings, the role of the psychiatrist in the general hospital setting was reexamined.