Enhancement of Proficiency in Liaison Psychiatry: An Educational Approach for Declining Misdiagnosis in Primary Care Setting

Abstract

The occurrence of medical errors in primary care settings is common and the likelihood of errors causing serious harm, as well, is high. It is estimated that around 10-15 percent of clinical diagnoses are incorrect and many patients, who after a while develop significantly more serious medical or neurological disorders, are initially diagnosed as conversion disorder. So, based on a case history design, all decisively medical patients, who had been misdiagnosed by at least one medical specialist as conversion disorder or so on in primary care setting, and accordingly had been referred to psychiatric facilities, during an eighteen months period , have been selected for the present study. Medical illnesses like Hallervorden-Spatz disease, Multiple Sclerosis, Myxoma of the Left Atrium, Epilepsy, and also malignancies like Mesothelioma, Metastatic Bone Tumor, and small cell (oat cell) carcinoma of the lung, were among the most serious medical illnesses that had been mislabeled by non-psychiatric medical specialists, and which had been revealed after repeated assessment that had been asked by a consultant psychiatrist. Careful medical examination, based on adequate clinical skills and knowledge, is necessary for diagnosis or ruling out of medical problems. Enhanced educational curriculums in medical schools, improvement of skills and knowledge of medical students in the field of somatic symptom disorder and consultation-liaison psychiatry, guideline modifications, continuous post-graduation education and system modifications possibly will help to decline the percentage of medical errors.