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January 1982

Psychiatrists Are also Physicians

Author Affiliations

Department of Psychiatry McLean Hospital 115 Mill St Belmont, MA 02178

Arch Gen Psychiatry. 1982;39(1):113-114. doi:10.1001/archpsyc.1982.04290010084019

To the Editor.  — Hall and his associates should be commended for dramatically documenting the importance of medical factors in causing psychiatric symptoms (Archives 1980;37:989-995). However, they left a few unanswered questions that lead me to disagree with their conclusion that psychiatric training should emphasize the medical aspects of psychiatry to prepare psychiatrists to be primary-care physicians.First, the authors report that the initial cursory physical examination was conducted by a general practitioner, but they do not specify who performed the detailed physical examinations.Second, the authors provide no detailed cases that describe the psychiatric care (including psychoatropic medications or psychotherapy or milieu approaches) that was provided and what the relationship was of this care (in addition to the medical treatment) to the patient's symptomatic improvement. The report suggests that medical treatment alone was the key to resolution or improvement of the psychiatric symptoms in 46% of their patients.