At the 35th Annual Meeting of the Japanese Society of General Hospital Psychiatry, a short forum was held titled “Research difficulties in the field of general hospital psychiatry (GHP)”. When we started planning this project, the authors assumed that we would give tips on conducting research to young medical professionals with little experience in research. However, according to a preliminary survey of the members of this society, it became clear that people with extensive clinical and research experience are interested in this project. In addition, problems unique to research in the field of GHP were highlighted, such as “there are no mentors,” “we must conduct research on patients from other departments other than psychiatry,” and “it is difficult to balance clinical practice and research.” Therefore, in the short forum, we modified the contents so that we could discuss issues in conducting research in the field of GHP together with the participants. In this article, I report the results of the preliminary survey, and also describe how the contents of the short forum was changed based on the results of them.

There are many difficulties in promoting research in a general hospital psychiatry department. One of them is the difficulty of conducting cross-departmental research. The author learned some lessons in cooperation with the Department of Anesthesiology through research on electroconvulsive therapy. From this experience, the author believes that the difficulties in cross-departmental research can be summarized as a lack of mutual understanding, disagreements in interests, differences in risks/benefits, and differences in rhythm and speed. To resolve these issues, it seems important to conduct a reconciliation process based on careful and time-consuming exchanges.

A short forum, “Stories of difficulties in research in the GHP field” was planned, in which I summarized my clinical research experience, which was conducted through trial and error in the perinatal field. At the beginning of the research, neither a senior doctor specializing in perinatal psychiatry nor a research group in the medical office was present. Consequently, I began from scratch, covering research field, execution, and topic selection, and developed a research plan with insights from my supervisor and advice from several close doctors. At the beginning of the research, building relationships with the staff in the research field was important, and I was able to obtain a joint researcher to proceed with the research. Balancing research with other duties like clinical and teaching is challenging; yet, forming a research team can significantly boost motivation and facilitate the research process. In addition, the “Perinatal Mental Health” committee in our society unites members from diverse fields. Sharing clinical and research challenges, along with exchanging a wide range of information, proves immensely beneficial.

While working as a psychologist at a general hospital, I have participated in and conducted several research studies. Specifically, I am currently engaged in research on family support for cancer patients and individualized consideration in cancer education at schools as my main research themes. Additionally, I have been involved in practical research on collaborative care with primary care doctors in the community. In such research in the field of psychiatry in general hospitals, I have felt that there are difficulties such as time constraints in parallel with clinical work, building a research team and dividing roles among multiple professions, and explaining and asking for help in the research field. We have looked back and considered what we have done (or are doing) to address these and other difficulties. Specifically, I considered joining research teams, fostering multidisciplinary collaboration in clinical practices, and addressing challenges by leveraging insights from clinical scenarios, like articulating and discussing clinical inquiries among the healthcare team.

In this short forum held at the 35th annual meeting of the Japanese Society of General Hospital Psychiatry, “Research difficulties in the field of general hospital psychiatry,” each speaker gave a presentation on the content and progress of the research in one’s own specialty area, as well as the difficulties encountered. Following the presentations, we aim to recommend the subsequent “hub functions” for research to the Society. These suggestions stem from the insightful discussions during the brief forum, enriched by active participation from the audience and further deliberations among forum members afterward. (1) Provide a welcoming space for individuals to openly seek advice on their research, and (2) Serve as a connecting “bridge” between researchers and their mentors, peers, and collaborators. Through this short forum, the needs for the Society to function as a hub in research were clarified. In the future, there are various issues that still need to be fully considered in order to actually establish a system to take on the hub function. In addition, collaboration and cooperation with the Society’s Board of Directors and existing committees will be essential.

The manuscript “Research difficulties in the field of general hospital psychiatry” which was written by young doctors, provides an overview of what they expect from the Japanese Society of General Hospital Psychiatry (JSGHP) and the problems currently faced by doctors in general hospitals. Based on this, I examined the strategies that the JSGHP could adopt. Establishing a new organization would be challenging due to time and personnel restrictions. Therefore, the existing organization and its many committees should be used more efficiently.

The field of general hospital psychiatry is an interesting area of research. It is an important field because the improvement of psychiatric symptoms of intervening patients in general hospital psychiatry, which can be called the front line of psychiatric care, often leads to improvement of physical illness and life prognosis. There are many research themes and challenges in this area. The usual liaison/consultation responses can be useful for research. These responses have the potential to ensure psychological safety and guide research teams more efficiently in accomplishing their research tasks. It is also important for the association to provide a good research environment for young researchers. Other academic societies are also making various efforts to deal with this issue from a long-term perspective. The Department of General Hospital Psychiatry is involved in disaster psychiatry and many other fields, and there are high social expectations for collaboration with other fields and joint research in multidisciplinary cooperation in the future. It is important for the academic society to create a system to promote young researchers in the field of GHP and research with multiple professions and other fields.

A short forum titled “Research Difficulties in the Field of General Hospital Psychiatry” was held at the 35th annual meeting of the Japanese Society of General Hospital Psychiatry. A lively discussion was exchanged on the issues involved in conducting research in the field of general hospital psychiatry. These issues were broadly divided into the following categories: research funding, research design and planning, research implementation, paper submission and others. In this paper, as a member of the board of directors of the Society, I would like to express my comments on the recommendations made in this short forum.

Timely decision-making regarding pharmacotherapy for patients with delirium is necessary. Therefore, nurses, in addition to psychiatrists, who are trained in pharmacological treatment of appropriate psychiatric medications are expected to play an important role in the treatment of delirium. However, the recognition of trained nurses is still low, and their usefulness as a nurse administering medications has not been fully investigated. In this study, we aimed to examine trained nurses on the treatment outcome of delirium. The medical records of 55 patients with delirium who were admitted to a general ward of a regional general hospital between May 2017 and March 2020 were consecutively surveyed. Treatment groups were categorized into two: patients managed solely by a group of trained nurses, and those treated through a collaborative effort between psychiatrists and trained nurses. The primary outcome measured was the number of days until remission following the initiation of delirium treatment intervention. The results revealed that the patients with delirium who were treated by the single group of trained nurses achieved remission significantly earlier compared to those who were treated with a collaborative approach by both psychiatrists and nurses (log-rank test, χ² = 7.04, p = 0.008). We obtained a similar result after adjusting for the severity of delirium by Cox proportional hazard model (hazard ratio = 2.06 [95% confidence interval, 1.14-3.71]). The present study demonstrates that nurses who are trained on specific medical acts regarding the administration of psychiatric medications may play an important role in the management of inpatients with delirium in general medicine wards.

We experienced a case of manic state with organic mood disorder triggered by acute hyperglycemia. The case was a man in his 60s with no history of psychiatric illness. Following his retirement, he became less careful about his diabetes management, and his eating habits were disturbed. He was admitted to our hospital with compulsory hospitalization. Post-hospital studies revealed severely poor glycemic control, and he was transferred to a general hospital where intensive insulin therapy was initiated. He returned to our hospital following the adjustment of his diabetes treatment. With his glycemic control stabilized, his manic symptoms subsided, leading to his discharge. Psychiatric hospitals offering emergency care, particularly compulsory admissions, must be vigilant for organic mental disorders in emergency situations. Furthermore, timely decisions to transfer patients for treatment of physical conditions to a general hospital are crucial. Equally important is maintaining regular collaboration with nearby general hospitals equipped with psychiatric units.