Understanding the Role of Somatic Symptoms Masking the Diagnosis of Psychiatric Illness in the Emergency Department: A Literature Review

The adult population has limited awareness of the coexistence of mental illness andsomatic complaints. People still stigmatize seeking mental health services, and they aretherefore more comfortable visiting the emergency department (ED) for their physicalcomplaints. These symptoms may be reflecting an underlying psychiatric disorder that isoften unknown at the time of the initial assessment. Many times in complex cases, thebody is displaying many symptoms, but the cause is a psychiatric illness, and there areoften delays in diagnosis. This review synthesizes evidence on factors associated withdelayed psychiatric recognition in patients with somatic symptoms. Many people withpersistent physical symptoms or physical symptoms with no known medical cause areassessed before a mental health condition is diagnosed. The existing evidence calls forbetter structured approaches to enable early identification and management of psychiatricconditions in patients with physical symptoms in the ED. This study highlights reasons fordelayed psychiatric diagnoses and identifies gaps in current clinical practice. Screeningtools and a structured mental health questionnaire used by the ED staff will assist in theearly detection of psychiatric disorders. Overall, the findings support integrating earlierpsychiatric assessment and multidisciplinary collaboration into ED practice. This willimprove diagnostic accuracy and patient outcomes. This review suggests future directionsto prevent the deterioration of the patient's mental health.