Abstract Understanding the psychological contribution to physical illness presentations is an important part of patient management in a general hospital setting, particularly when managing patients with chronic physical or terminal illnesses. In the presence of psychiatric morbidity, one should assess risk, especially suicidal intent. Where psychiatric problems are complex, a referral to a psychiatric team should be initiated. One should be mindful of drug interactions when prescribing psychotropic medications. However, pharmacological treatments are not the only form of therapy in psychiatry, psychological approaches can be equally effective.