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August 27, 1982

Toward Better Integration of Medical and Psychiatric Care

Author Affiliations

The Johns Hopkins Hospital Baltimore

JAMA. 1982;248(8):977. doi:10.1001/jama.1982.03330080059032

The article by Dr Hoffman in this issue of The Journal (p 964) is timely and important. Efforts to integrate medical and psychiatric care of patients such as described underscore how poorly medical and psychiatric care of patients is sometimes integrated. This lack of integration persists despite the awareness, since ancient times, of the association between physical and psychological disturbance and, more recently, epidemiologic work that clearly demonstrates this association.1 It has been estimated that of the 15% of the population of the United States that is psychiatrically ill and in need of mental health services, approximately 60% are seen in the general health care setting.2 Epidemiologic surveys report the prevalence of psychiatric disorder to be anywhere from 30% to 60% among medical inpatients and from 50% to 80% among medical outpatients.3 Studies conducted at The Johns Hopkins Hospital have shown that anywhere from 29% to 37%