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Samuel A. Nigro, MD

JAMA. 1970;214(9):1657-1660.

Abstract
A psychiatrist returning to part-time general practice in a suburban general hospital emergency room managed 469 patients in five months. Patients were assigned one of nine categories as indicators of the degree of psychological attention needed. More than half of the sample had "pure" medical-surgical problems. More than one fourth had problems primarily of psychological origin. Less than 12% were physically sick enough for admission; psychiatric help was recommended for 8%. All patients, directly or indirectly via relatives, required attention in a psychologically sound manner. The frequency of psychological problems indicates that medical facilities are in a psychosocial epidemic. The psychiatrist felt his perception of and way of dealing with patients was markedly affected by his specialty training in comparison to his prepsychiatry practice.

Author Affiliations
From the Child Psychiatry Division, Department of Psychiatry, Case Western Reserve University School of Medicine, and University Hospitals, Cleveland.

Footnotes
Reprint requests to University Hospitals, Cleveland 44106 (Dr. Nigro).

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