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 Evaluation of Psychiatric Morbidity in COVID-19-Positive Inpatients Referred to Consultation Liaison Psychiatry in a Tertiary Care Hospital

2021 ◽  
pp. 025371762110221
Author(s):  
Nisha K. Prajapati ◽  
Nimesh C. Parikh ◽  
Nilima D. Shah ◽  
Vinodkumar M. Darji ◽  
Heena B. Jariwala ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Adjustment Disorder ◽  
P Value ◽  
Fisher Exact Test ◽  
Care Hospital ◽  
Liaison Psychiatry ◽  
Exact Test ◽  
Consultation Liaison Psychiatry

Background: The COVID-19 pandemic has led to the risk of common mental illnesses. Consultation liaison psychiatry has been one of the most requested services in the face of this pandemic. We aimed to assess (a) the prevalence of psychiatric illness, (b) different types of psychiatric diagnoses, (c) presenting complaints, (d) reasons for psychiatric referrals, and (e) psychiatric intervention done on COVID-19 positive inpatients referred to consultation liaison psychiatry at tertiary care hospital. Method: This was a retrospective study of data collected from April 1, 2020, to September 15, 2020. Total 300 patients were referred and diagnosed with clinical interview and Diagnostic and Statistical Manual for Mental Disorder Fifth Edition criteria. Analysis was done using chi-square test, Kruskal–Wallis test, and fisher exact test. Results: Out of 300 patients, 26.7% had no psychiatric illness. Adjustment disorder was the commonest psychiatric diagnosis (43%), followed by delirium (10%). Statistically significant differences were found for parameters like Indian Council of Medical Research Category 4 of the patient, (hospitalized severe acute respiratory infection) (P value < 0.001), medical comorbidity (P value = 0.023), and past history of psychiatric consultation (Fisher exact test statistic value <0.001). Behavioral problem (27.6%) was the commonest reason for psychiatric referral. Worrying thoughts (23.3%) was the most frequent complaint. A total of 192 (64.3%) patients were offered pharmacotherapy. Conclusions: Psychiatric morbidity was quite high (73.3%) among them and adjustment disorder was the commonest (43%) psychiatric diagnosis followed by delirium (10%). Pharmacotherapy was prescribed to 64.3% patients and psychosocial management was offered to most of the referred patients.

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 A Descriptive study of referral in Department of Psychiatry in Tertiary Hospital in Nepal

2014 ◽  
Vol 2 (2) ◽  
pp. 22-25
Author(s):  
M Chapagai ◽  
KM Dangol ◽  
SP Ojha ◽  
M Rana ◽  
P Tulachan
Keyword(s):  
Descriptive Study ◽  
Tertiary Hospital ◽  
University Teaching ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Organic Mental Disorders ◽  
The Mean ◽  
Definition Of ◽  
Inpatient Units ◽  
Mental And Behavioral Disorders

Background There are many definition of liaison psychiatry. The American Academy of psychosomatic medicine has suggested the term “medical and surgical psychiatry”. Much of the literature on Consultation Liaison (C-L) Psychiatry concerns the psychiatric assessment and management of patients in a general hospital.   Method This was a descriptive study consisting of all the cases referred for liaison psychiatric consultation from inpatient units of various departments of Tribhuvan University Teaching Hospital, between October 2012 to April 2013. Patients of any age and of either gender were included.   Result A total of 95 patients were referred from different departments of the hospital for liaison psychiatric consultation within the 6 months period. Majority of the subjects were male .The mean age of the subjects was 42.47 years (±19.98). Neurotic and stress-related disorders were seen associated with female.   Conclusion: Mainly young adults and adult between 21-50 years of age are referred for liaison. Neurotic and stress-related disorders (30.5%), organic mental disorders (27.4%) and mental and behavioral disorders due to substance use cases (16.8%) were mainly referred for liaison psychiatric consultation. DOI: http://dx.doi.org/10.3126/jpan.v2i2.9721   J Psychiatrists’ Association of Nepal Vol.2, No.2, 2013 22-25     

scholarly journals Need Assessment of Consultation Liaison Psychiatry amongst the Clinical Faculty

2017 ◽  
Vol 53 (02) ◽  
pp. 097-103
Author(s):  
Rakesh K Chadda ◽  
Koushik Sinha Deb ◽  
Sathya Prakash ◽  
Mamta Sood
Keyword(s):  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Faculty Members ◽  
Psychological Problems ◽  
Psychosocial Issues ◽  
Clinical Faculty ◽  
Liaison Psychiatry ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Consultation Liaison Psychiatry

ABSTRACTNearly 20-40% of patients with medico-surgical illnesses in general hospitals have a co morbid psychiatric illness or psychosocial issues, which interfere in improvement of the primary illness. It is important to assess the attitudes and awareness of non-psychiatrist clinicians about the co-existing psychiatric morbidity in their patients and their felt needs, which can help in mitigating this morbidity. The present study attempts to gauge the non-psychiatrist clinician's perception, felt needs and barriers to referral/ intervention in a tertiary care teaching hospital. A cross-sectional, descriptive, online questionnaire-based method was used. Of the 239 clinical faculty members, only 45 responded. Responses indicated that clinicians were aware of the existence and significance of psychological problems in their patients, but could do with further increased levels of awareness and more specific training in evaluation and intervention. Stigma, lack of awareness of available services, and lack of detailed understanding regarding psychological problems were the important barriers to referral/ intervention. Better teamwork, training and more manpower were the specific suggestions for improvement in the future.

scholarly journals Psychiatric morbidity in epilepsy

2017 ◽  
Vol 5 (10) ◽  
pp. 4267 ◽  
Author(s):  
Prem Singh ◽  
Achyut K. Pandey
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Psychiatric Morbidity ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
The Mean ◽  
Antiepileptic Medications ◽  
Generalized Epilepsy ◽  
One Year ◽  
Patients With Epilepsy

Background: Psychiatric morbidity occurs more frequently in patients with epilepsy than in the general population. Routine evaluation and treatment of psychiatric morbidity can be helpful in improving epilepsy care but such data are relatively meagre from developing countries.Methods: The study was conducted in the Epilepsy Clinic of Department of Neurology at a tertiary care hospital over a period of one year.101 patients were included after fulfilling the inclusion criteria. All the patients seeking treatment in the OPD were screened, assessed and then all procedures were fully explained to them. History regarding name, age sex, socio-demographic profile and detailed history regarding seizure disorder was taken from both the patient and the reliable informant. Bengali version of SRQ-24 was used to screen for psychiatric morbidity.Results: One hundred and one patients with epilepsy consisting of 70 men (69.3%) and 31 women (30.7%) were included. Their ages ranged from 15 to 52, the mean age being 26.17 (SD = 7.84). Out of the 101 patients, 65 patients (64.4%) were suffering from partial epilepsies and 36 patients (35.6%) were suffering from generalized epilepsies. 50.49% of the subjects screened positive for psychiatric morbidity. Psychiatric morbidity was higher in unmarried, unemployed males from rural background who were suffering from generalized epilepsy and taking multiple antiepileptic medications. Psychiatric morbidity was statistically significant in people with poor education and those born at home (p<0.05) as compared to well educated, institutionally born persons.Conclusions: 50.49% of the subjects screened positive for psychiatric morbidity.

scholarly journals Patterns Of Psychiatric Referrals In A Tertiary Hospital

2020 ◽  
Vol 9 (2) ◽  
pp. 48-52
Author(s):  
R Niroula ◽  
PK Chakrabortty ◽  
P Thapa ◽  
JB Khattri ◽  
K Ramesh
Keyword(s):  
Anxiety Disorder ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Somatoform Disorder ◽  
Care Hospital ◽  
Psychiatric Consultation ◽  
Liaison Psychiatry ◽  
Medicine Department ◽  
Icd 10

Introduction: Consultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to patients under non-psychiatric care. Despite evidence of benefits of CLP for patients with psychiatric comorbidities, referral rates from hospital doctors remain low. This has prompted the present study, to assess the frequency and the pattern of psychiatric referral in a tertiary hospital in Nepal. Material And Method: This was a descriptive cross‑sectional study conducted in a tertiary care hospital. The study comprised of 108 patients referred for psychiatric consultation from various out-patient departments (OPD) to C‑L services of psychiatry department. Information was collected using semi‑structured proforma, and diagnosis was made based on Diagnostic Criteria for Research (ICD-10 DCR)and the data were analyzed. Results: A total of 108 patients, male 41(38%) and female: 67(62%) were referred to CLP, the Medicine department sent the maximum number of consultations (57.4%), followed by E.N.T (25.9%), Surgery (16.7%). Psychiatric consultation was sought for various reasons including decreased sleep (37%), appears anxious (27.8%), appears depressed (15.7%), foreign body sensation (11.1%), and mass moving in abdomen (8.3%).The most prevalent ICD-10 diagnosis was depressive episode (44.4%) followed by anxiety disorder (27.8%) and somatoform disorder (19.4%). Conclusion: Our study illustrates the importance of CLP through referral pattern from various OPD in a tertiary care hospital. Majority of referrals were from Medicine department andthe most common reason of referral was decreased sleep. The commonest diagnosis seen in the referred out-patients was depression followed by anxiety disorder and somatoform disorder.

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.

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