Retrospective Analysis of Cases Consulted at the Department of Psychiatry in a General Hospital in Guangzhou, China

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Zhang LL ◽  
◽  
Zhao JP ◽  
Keyword(s):  
General Hospital ◽  
Somatoform Disorders ◽  
Somatic Symptoms ◽  
Generalized Anxiety ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Consultation Model ◽  
Primary Reference ◽  
Consultation Liaison Psychiatry ◽  
Clinical Departments

Objective: To comprehensively analyze cases of psychiatric consultation in a general hospital and provide a primary reference for the development of consultation-liaison psychiatry. Method: A retrospective study was conducted by analyzing data collected over a two-year period regarding psychiatric consultations from the inpatient registry in a general hospital. Results: A total of 926 and 774 psychiatric consultations were recorded in 2016 and 2017, respectively. The most common reason for consultation was unexplained somatic symptoms. Consultations based on psychological evaluation, and mental/behavioral disorders due to organic diseases and perioperative stress were significantly higher in 2017 than those in 2016 (P<0.01). Diagnoses of neurotic, stress-related and somatoform disorders were significantly lower in 2017 compared to those in 2016 (269 (34.8%) cases in 2017 vs. 373 (40.3%) cases in 2016; P=0.019). Among specific diagnoses, generalized anxiety disorder was the most common. Conclusion: Most patients with depressive or anxiety disorders visit a general hospital due to somatic symptoms. It is necessary to train nonpsychiatrists to identify mental disorders efficiently, as well as to extend the comprehensive consultation model to include more clinical departments.

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

Psychiatric Consultations in a Canadian General Hospital

1979 ◽  
Vol 24 (8) ◽  
pp. 717-723 ◽  
Author(s):  
Graeme Taylor ◽  
Kenneth Doody
Keyword(s):  
Nursing Education ◽  
General Hospital ◽  
The United States ◽  
Psychiatric Ward ◽  
Medical Setting ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry ◽  
Consultation Services ◽  
Psychiatric Problems

This paper reports a survey of psychiatric referral patterns on the inpatient wards of a Canadian general hospital over a 5-year period. The results demonstrate the useful contributions which psychiatric consultants can make to the care of physically ill patients. The most frequent consultation requests were for assistance with diagnostic problems and the management of depression or other psychopathology accompanying physical illness. The majority of consultation patients, 69.4%, had concurrent physical and psychiatric diagnoses and could be managed collaboratively on the services from which they were referred. Only 6.64% of the referred patients were transferred to a psychiatric ward, which reflected the philosophy of the consultation-liaison service to treat the psychiatric problems of the physically ill in the medical setting. The findings from the survey are compared with reports from general hospitals in Britain and the United States where the underutilization of psychiatric consultation services has been well demonstrated. Factors influencing the referral process, including liaison activities, are discussed and the limitations of consultation-liaison psychiatry, acknowledged. Changes in medical and nursing education are suggested to promote the wider practice of comprehensive patient care.

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 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.

Progress and Evaluation of a Consultation-Liaison Psychiatry Service to an Obstetric-Gynaecology Hospital

1996 ◽  
Vol 30 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Nicole Phillips ◽  
Lorraine Dennerstein ◽  
Stephen Farish
Keyword(s):  
Patient Satisfaction ◽  
Consumer Satisfaction ◽  
Referral Rate ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
High Patient Satisfaction ◽  
Charge Nurses ◽  
Objective Evidence ◽  
Consultation Liaison Psychiatry

Objective: Recently we described the establishment and first 6 months of a psychiatric consultation-liaison service to a Melbourne obstetric-gynaecology teaching hospital. The follow-up report evaluates the service in two ways: first, it compares referral data for the 12 months of 1992 with that of the first 6 months of operation in 1990; and second, it reports on results of a survey of referrer and patient satisfaction with the service. Method: Referral data were collected for the data comparison from the consultation-liaison referral book and patients' files. Referrer and patient satisfaction was evaluated by questionnaires sent to 45 medical staff, 7 charge nurses, and 100 consecutive patients. Result: A fairly constant referral rate for inpatients has emerged at 0.8%, this very low referral rate being some cause for concern. An internal shift in the type of referrals over time has developed, with an increase in obstetric and a decrease in gynaecology referrals. High referrer satisfaction, with 86% of the doctors finding the consultation(s) “very” or “quite” helpful, and high patient satisfaction, with 83% of respondents having found the consul tat ion(s) “very” or “quite” helpful, was found. Conclusions: Despite high referrer and consumer satisfaction, and objective evidence of need, this pioneering consultation-liaison service in obstetric-gynaecology continues to be grossly under-utilised. Increasing the referral rate will be one of the greatest challenges in the future of this service.

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