Working in a general hospital psychiatry department, the authors treat patients with psychiatric emergencies who also have physical complications. Three primary treatment paradigms exist. The first is the medical management of patients with psychiatric emergencies who also have physical illnesses. Physical complications may occur due to external injury, internal secretions,metabolic disease, and treatment for psychiatric emergencies. In such cases, patients require not only psychiatric treatment but also medical treatment for their physical symptoms or problems. The second pattern is the management of patients brought to the emergency department after a suicide attempt. In this case, the cause of the physical complications is action derived from suicidal ideation,and somatic therapy is given priority. The third pattern is the often difficult management of physical illness in patients who suffer from chronic psychiatric illness. In a general hospital with no department of psychiatry, psychiatric patients with physical emergencies are often unable to obtain appropriate diagnosis and treatment. There is a greater need for general hospitals able to manage psychiatric emergencies and their physical complications during medical treatment.