In order to evaluate how many patients presenting at accident and emergency (A&E) departments show signs of psychiatric disturbance, 140 consecutive medical presentations to an A&E department were evaluated using a range of simple self-report and rater measures, then followed up a month later. High levels of reported psychological problems were detected at screening, and these persisted at follow-up. Correlates of psychological disturbance and repeated attendance at A&E were investigated, indicating the relevance and feasibility of psychiatric intervention related to simple predictors.