Psychiatric Quarterly [psaq] ph183-psaq-460942 May 9, 2003 18:34 Style ﬁle version June 4th, 2002
Psychiatric Quarterly, Vol. 74, No. 3, Fall 2003 (
Medical Illnesses and Complications
in Psychiatric Patients
C. Deborah Cross, M.D.
It is well known that psychiatric patients have signiﬁcant medical ill-
nesses which often go unrecognized and untreated. The three articles in
this Special Section deal with some of these illnesses and complications
that psychiatrists need to be cognizant of in order to more effectively
care for their patients.
The ﬁrst article by Price and Goyette focuses on two of the more difﬁ-
cult to treat chronic illnesses in psychiatric patients; HIV and Hepatitis
C (HCV). Though the treatment of HIV infection has progressed to the
point that the illness is, by and large, considered chronic rather than fa-
tal, the complexity of treatment with the multiplicity of providers and
medications makes caring for these patients a daunting task for the
psychiatrist. The mortality and morbidity of HCV is only now begin-
ning to be recognized. The rate of new cases is increasing dramatically.
Price and Goyette discuss both the challenges and the opportunities
available to the psychiatrist in treating these two complex patient pop-
ulations and uses a case example to highlight the necessity for close
collaboration between all providers.
Lebovitz’s article discusses the metabolic complications that occasion-
ally occur in patients treated with atypical antipsychotic medications.
Though Lebovitz points out that it has been known for several decades
that patients with schizophrenia have an increased prevalence of Type 2
diabetes, the advent of the atypical antipsychotics have, it appears, sig-
niﬁcantly increased that risk. He summarizes the existing scientiﬁc
data and offers a monitoring schema for patients on atypical antipsy-
chotic medications. He also stresses that the psychiatrist and patient
must often make difﬁcult therapeutic choices regarding alleviation of
2003 Human Sciences Press, Inc.