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A Comparison of Psychiatric Consultation–Liaison Services Between Hospitals in the United States and Japan

Received December 26, 2005; revised July 8, 2006; accepted July 13, 2006. From the Dept. of Psychiatry, Univ. of Minnesota; the Dept. of Psychiatry, Tokai University; the Dept. of Psychiatry, Saitama Medical Center, Saitama Medical School; the Dept. of Psychiatry, Saitama Psychiatric Center; the Dept. of Psychiatry, Nagoya City University; and the Dept. of Psychology, Woodland Centers. Send correspondence and reprint requests to Dr. Yasuhiro Kishi, Dept. of Psychiatry, Saitama Medical Center, 1981 Tsujido-machi, Kamoda, Kawagoe Saitama, 350-8550, Japan. e-mail (Dr. Thurber): steven_thurber{at}yahoo.com
© 2007 The Academy of Psychosomatic Medicine

The authors investigated psychiatric consultation in two hospitals, one in the United States, the other in Japan. They examined similarities and differences, and drew inferences on possible cross-cultural values and/or temporary cultural conditions. As compared with the Japanese consultation patients, the Americans had more mood disorders, including anxiety and chemical-dependency problems, in respective diagnostic classifications. Patients in the United States also showed more acute as well as more serious chronic conditions. These differences may relate to disorder base-rates in the respective countries. In general, psychosocial problems emerged as ascendant in Japan, as compared with chemical-dependency difficulties among American patients. The results are discussed in terms of current conditions in Japan that affect the mental health professions, together with attempts by Japanese clinicians to protect collective mores by ascribing causation for disorders to the individual, rather than the societal conditions often invoked in the United States.

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