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Psychosomatic medicine is rooted in consultation-liaison psychiatry, having expanded from a handful of general medical wards in the 1930s to specialized medical units throughout various parts of the health care delivery system. Practitioners in this psychiatric subspecialty assist with the care of a variety of patients, especially those with complex conditions such as cancer, organ failure, HIV infection, dementia, delirium, agitation, psychosis, substance use disorder or withdrawal, somatic symptom disorder, personality disorders, and mood and anxiety disorders, as well as suicidal ideation, treatment nonadherence, and aggression and other behavioral problems (Gitlin et al. 2004; Hackett et al. 2010). In addition, ethical and legal considerations are often critical elements of the psychiatric consultation. In the medical setting, prompt recognition and evaluation of psychiatric problems are essential because psychiatric comorbidity commonly exacerbates the course of medical illness, causes significant distress, prolongs hospital length of stay, and increases costs of care.
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