Skip to main content
Log in

Physical illness among all discharged psychiatric inpatients in a national case register

  • Brief Reports
  • Published:
The journal of mental health administration Aims and scope Submit manuscript


Previous studies have found that although psychiatric patients tend to have more physical illness than the rest of the population, it frequently goes unrecognized and untreated in psychiatric settings. This study investigated rates of reported physical illness among hospitalized psychiatric patients in preparation for national reform in mental health services. Data from the Israeli National Psychiatric Case Registry were analyzed on reported physical illness among all 38,714 psychiatric discharges during 1989–1991. Physical illness was reported for 10.62% of patients under age 25, 14.4% of patients 25 to 44, 34.27% of patients 45 to 65, and 61.26% of patients 65 and older. Rates differed among hospitals. Reported physical illness was considerably lower than expected as compared with other studies. Underdiagnosis is suggested as a possible explanation. Study results were used to add differential payment for physical comorbidity under the new National Health Insurance Law. Other corrective measures are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.


  1. Koranyi EK: Morbidity and rate of undiagnosed physical illnesses in a psychiatric clinic population.Archives of General Psychiatry 1979; 36:414–419.

    PubMed  CAS  Google Scholar 

  2. Bartsch DA, Shern DL, Feinberg LE, et al.: Screening CMHC outpatients for physical illness.Hospital and Community Psychiatry 1990; 41:786–790.

    PubMed  CAS  Google Scholar 

  3. Maricle RA, Hoffman WF, Bloom JW, et al.: The prevalence and significance of medical illness among chronically mentally ill outpatiens.Community Mental Health Journal 1987; 23:81–90.

    Article  PubMed  CAS  Google Scholar 

  4. Koran LM, Sox HC, Marton KI, et al.: Medical evaluation of psychiatric patients: Results in a state mental health system.Archives of General Psychiatry 1989; 46:733–740.

    PubMed  CAS  Google Scholar 

  5. Davies EW: Physical illness in psychiatric out-patients.British Journal of Psychiatry 1965; 111:27–33.

    PubMed  CAS  Google Scholar 

  6. Koranyi EK: Somatic illness in psychiatric patients.Psychosomatics 1980; 21:887–889.

    PubMed  CAS  Google Scholar 

  7. Hall RCW, Popkin MK, Devaul RA, et al.: Physical illness presenting as psychiatric disease.Archives of General Psychiatry 1978; 35:1315–1320.

    PubMed  CAS  Google Scholar 

  8. Hall RCW, Beresford TP, Gardner ER, et al.: The medical care of psychiatric patients.Hospital and Community Psychiatry 1982; 33:25–34.

    PubMed  CAS  Google Scholar 

  9. Honig A, Pop P, Tan ES, et al.: Physical illness in chronic psychiatric patients from a community psychiatric unit. The implications for daily practice.Britsh Journal of Psychiatry 1989; 155:58–64.

    CAS  Google Scholar 

  10. Sox HCJ, Koran LM, Sox CH, et al.: A medical algorithm for detecting physical disease in psychiatric patients,Hospital and Community Psychiatry 1989; 40:1270–1276.

    PubMed  Google Scholar 

  11. Knutsen E, DuRand C: Previously unrecognized physical illnesses in psychiatric patients.Hospital and Community Psychiatry 1991; 42:182–186.

    PubMed  CAS  Google Scholar 

  12. Hinkle LE, Wolff HG: The nature of man’s adaptation to his total environment and the relation of this to illness.Archives of Internal Medicine 1957; 99:442–460.

    Google Scholar 

  13. Eastwood MR, Trevelyan MH: Relationship between physical and psychiatric disorder.Psychological Medicine 1972; 2:363–372.

    PubMed  CAS  Google Scholar 

  14. Lipowski ZJ:Psychosomatic Medicine and Liaison Psychiatry. Selected papers. New York: Plenum, 1985.

    Google Scholar 

  15. Lipowski ZJ: The interface of psychiatry and medicine: Towards integrated health care.Canadian Journal of Psychiatry 1987; 32:743–748.

    CAS  Google Scholar 

  16. Hankin JR, Steinwachs DM, Reiger DA, et al.: Use of general medical care services by persons with mental disorders.Archives of General Psychiatry 1982; 39:225–231.

    PubMed  CAS  Google Scholar 

  17. Fink P: Mental illness and admission to general hospitals: A register investigation.Acta Psychiatrica Scandinavica 1990; 82:458–462.

    Article  PubMed  CAS  Google Scholar 

  18. Fink P: Physical disorders associated with mental illness: A register investigation.Psychological Medicine 1990; 20:829–834.

    Article  PubMed  CAS  Google Scholar 

  19. Mechanic D: Integrating mental health into a general health care system.Hospital and Community Psychiatry 1994; 45:893–897.

    PubMed  CAS  Google Scholar 

  20. Mark M, Rabinowitz J, Feldman D, et al.: Reform in mental health services in Israel: The changing role of government, HMO’s and hospitals,Administration and Policy in Mental Health 1995; 23(3):253–259.

    Article  Google Scholar 

  21. Popper M, Horowitz R:Psychiatric Hospitalization of Immigrants 1990–1991. Statistical Report No. 7 (In Hebrew) ed. Jerusalem: Israel Ministry of Health, Department of Information and Evaluation, 1992.

    Google Scholar 

  22. U.S. Department of Health and Human Services:Vital and Health Statistics, Current Estimates form the National Health Interview Survey. Series 10, No. 173 ed. Washington, DC: U.S. Department of Health and Human Services, 1989.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Jonathan Rabinowitz D.S.W..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rabinowitz, J., Mark, M., Popper, M. et al. Physical illness among all discharged psychiatric inpatients in a national case register. The Journal of Behavioral Health Services & Research 24, 82–89 (1997).

Download citation

  • Issue Date:

  • DOI: