Associations between early consultation-liaison psychiatry intervention and subsequent length of stay in general hospital

2018 ◽  
Vol 109 ◽  
pp. 143-144
Author(s):  
H. Vulser ◽  
V. Vinant ◽  
G. Chatellier ◽  
F. Limosin ◽  
C. Lemogne
Keyword(s):  
Length Of Stay ◽  
General Hospital ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry

scholarly journals Diagnostic Agreement between Physicians and a Consultation–Liaison Psychiatry Team at a General Hospital: An Exploratory Study across 20 Years of Referrals

2021 ◽  
Vol 18 (2) ◽  
pp. 749
Author(s):  
Mattia Marchi ◽  
Federica Maria Magarini ◽  
Giorgio Mattei ◽  
Luca Pingani ◽  
Maria Moscara ◽  
...  
Keyword(s):  
General Hospital ◽  
Depressive Disorders ◽  
Psychiatric Morbidity ◽  
Clinical Signs ◽  
Kappa Statistics ◽  
Comorbid Depression ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry ◽  
Psychiatric Conditions ◽  
Diagnostic Concordance

Consultation–liaison psychiatry (CLP) manages psychiatric care for patients admitted to a general hospital (GH) for somatic reasons. We evaluated patterns in psychiatric morbidity, reasons for referral and diagnostic concordance between referring doctors and CL psychiatrists. Referrals over the course of 20 years (2000–2019) made by the CLP Service at Modena GH (Italy) were retrospectively analyzed. Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by CL psychiatrist and the diagnoses considered by the referring doctors. The analyses covered 18,888 referrals. The most common referral reason was suspicion of depression (n = 4937; 32.3%), followed by agitation (n = 1534; 10.0%). Psychiatric diagnoses were established for 13,883 (73.8%) referrals. Fair agreement was found for depressive disorders (kappa = 0.281) and for delirium (kappa = 0.342), which increased for anxiety comorbid depression (kappa = 0.305) and hyperkinetic delirium (kappa = 0.504). Moderate agreement was found for alcohol or substance abuse (kappa = 0.574). Referring doctors correctly recognized psychiatric conditions due to their exogenous etiology or clear clinical signs; in addition, the presence of positive symptoms (such as panic or agitation) increased diagnostic concordance. Close daily collaboration between CL psychiatrists and GH doctors lead to improvements in the ability to properly detect comorbid psychiatric conditions.

scholarly journals Pattern of psychiatric morbidity among referred inpatients in a tertiary care hospital of Bangladesh

2020 ◽  
Vol 31 (2) ◽  
pp. 38-42
Author(s):  
Nasim Jahan ◽  
Mohammad Muntasir Maruf ◽  
Sharmin Kauser ◽  
Mekhala Sarkar ◽  
Md Masud Rana Sarker ◽  
...  
Keyword(s):  
General Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Major Depressive ◽  
Consultation Liaison Psychiatry ◽  
The Mean ◽  
Inpatient Units

There is a dearth of studies related to consultation-liaison psychiatry in Bangladesh. The psychiatric referral rates in this country are very low, considering the higher rates of psychiatric morbidity in patients who attend various departments of a general hospital. This was a descriptive study consisting of all the cases referred for psychiatric consultation from inpatient units of various departments of BIRDEM General Hospital, Dhaka from July 2017 to June 2018. Patients of any age and of either gender were included. A total of 673 patients (1.97% of total admission) were referred from different departments of the hospital for psychiatric consultation within the study period. Majority of the respondents were female. The mean age of the respondents was 59.47 (±1.98) years. Among the referred, Generalized anxiety disorder (GAD) was the diagnosis in 24.96%, followed by Major depressive disorder (MDD) in 9.95% cases. Referral from the department of Medicine and allied was 92.86 %, followed by department of Surgery and allied (6.38%) & department of Obstetrics and Gynaecology (0.74%). Frequency of referral was the lowest in the months of November to January. There is a need to encourage multi-disciplinary interaction in the management of patients who attend general hospitals, so as to better identify the psychiatric morbidity. Bang J Psychiatry December 2017; 31(2): 38-42

scholarly journals Substance use and psychiatric disorders in patients referred to consultation-liaison psychiatry within a regional general hospital

2021 ◽  
Author(s):  
Murray Tucker ◽  
Harry Hill ◽  
Emma Nicholson ◽  
Steven Moylan
Keyword(s):  
Substance Use ◽  
Psychiatric Disorders ◽  
General Hospital ◽  
Psychiatric Diagnosis ◽  
Diagnostic Category ◽  
Adjustment Disorder ◽  
Post Traumatic Stress ◽  
Liaison Psychiatry ◽  
Hospital Patients ◽  
Consultation Liaison Psychiatry

Abstract Little is known about clinically important differences between patients depending on the number of comorbid psychiatric disorders, or the presence or absence of a substance use disorder (SUD) comorbidity. This study investigated for differences in psychosocial disadvantage, psychiatric disorders, and health service amongst 194 general hospital patients referred to consultation-liaison psychiatry (CLP) with no psychiatric diagnosis, single psychiatric diagnosis, multiple (non-SUD) psychiatric diagnoses, or psychiatric diagnosis plus SUD comorbidity. The results showed that SUDs were the commonest diagnostic category (34%). The SUD comorbidity group had more disadvantaged housing, were prescribed most psychoactive medications, and 20% prematurely self-discharged against medical advice. Increased SUDs were associated with reduced length of stay, men, younger age, increased investigations, and reduced private health insurance subscription. Patients with SUD comorbidity versus multiple psychiatric diagnosis had reduced odds of Adjustment Disorder, Somatic Symptom Disorder, and Insomnia Disorder. Post Traumatic Stress Disorder was the strongest predictor of multiple SUDs, followed by Cluster B personality disorders. In conclusion, SUDs have become a leading clinical focus for CLP. The presence or absence of SUDs amongst patients with multiple psychiatric disorders has important clinical implications for engagement, diagnosis, prescribing, and outpatient follow-up.

scholarly journals Working in consultation-liaison psychiatry in the USA

1989 ◽  
Vol 13 (3) ◽  
pp. 123-126 ◽  
Author(s):  
Paul Foster
Keyword(s):  
General Hospital ◽  
Health Care Systems ◽  
Theoretical Background ◽  
Liaison Psychiatry ◽  
Psychiatric Units ◽  
Care Systems ◽  
The Usa ◽  
Consultation Liaison Psychiatry ◽  
General Wards ◽  
Role Boundaries

Consultation-liaison psychiatry had its inception in North America, the term making its first appearance in the 1930s to describe the department at Colorado General Hospital in Denver. As Mayou (1987) points out, when comparing British and American liaison services, the role, boundaries, and organisation of this subspecialty are very different in the two countries. Money and resources do not exist in Britain within the National Health Service to provide the extent of involvement liaison psychiatry now enjoys with the general wards of many American hospitals. Thomas (1985) refers to basic differences between the countries. He points out that few British district general hospitals have consultation psychiatric units now in place and that the theoretical background of psychiatrists in the two countries are different. In addition, he suggests that there may well be differences in the referral patterns and expectations with regard to psychiatric consultation requirements of general hospital doctors in the two health care systems.

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