scholarly journals Psychiatry in the renal unit

2001 ◽  
Vol 7 (6) ◽  
pp. 426-432 ◽  
Author(s):  
Andrew Phipps ◽  
Douglas Turkington
Keyword(s):  
Renal Unit ◽  
Liaison Psychiatry ◽  
Physical Problems ◽  
Assessment And Treatment ◽  
Unique Experience ◽  
Consultation Liaison Psychiatry ◽  
The Common ◽  
Psychiatric Problems ◽  
Multi Disciplinary Team

Consultation–liaison psychiatry in renal medicine provides a unique experience for the psychiatrist. There is the opportunity to work with a specialist multi-disciplinary team managing patients with chronic and complex physical problems in in-patient and out-patient settings. We aim to consider the common psychiatric problems experienced by renal patients and the particular problems that face the renal team and the liaising psychiatrist in relation to assessment and treatment.

Consultation-Liaison Psychiatry to Renal Medicine: Work with an Inpatient Unit

1996 ◽  
Vol 30 (2) ◽  
pp. 229-237 ◽  
Author(s):  
Sabar Rustomjee ◽  
Graeme C. Smith
Keyword(s):  
Alcohol Problems ◽  
Inpatient Unit ◽  
Renal Unit ◽  
Clinical Database ◽  
Liaison Psychiatry ◽  
Consultant Psychiatrist ◽  
Consultation Liaison Psychiatry ◽  
Organic Brain ◽  
High Level ◽  
Good Agreement

Objective: To provide an overview of the work of a liaison psychiatry service to a renal medicine inpatient unit, based on a comprehensive clinical database, in order to provide a basis for comparison with similar units and to identify issues of concern. Method: The MICRO-CARES prospective clinical database system was used to obtain data on all patients referred to the Liaison Psychiatry Service, and the hospital clinical database was used to compare referred patients with total Renal Unit admissions in a large, suburban, university-affiliated hospital. Results: Two hundred and ninety-nine inpatient referrals were made in the three years from 1990 to 1992: a referral rate of 17%. There was no bias in referral on age, sex or marital status. Coping problems (27%), depression (20%) and noncompliance (11%) were the most frequent reasons cited. Forty-five per cent of referrals required a pre-dialysis assessment. There was good agreement between consultee and consultant about noncompliance, but poorer agreement about organic brain syndromes, depression, anxiety and alcohol problems. The highest prevalence of DSM-III-R diagnoses was for V Codes (35% of patients), Adjustment Disorders (30%), Mood Disorders (24%) and Organic Mental Disorders (23%). Referred patients had a length of stay significantly longer than that of the total admissions (20.5 days ± 20.6 SD compared with 8.7 ± 12.5 SD, p<.001). Psychotropic drugs were prescribed in 25% of referrals, and liaison psychiatry staff spent a mean of 181 ±148 SD minutes per patient, reflecting the emphasis on psychological management. The systems issues are discussed. Conclusions: The high level of complex physical/psychiatric comorbidity present and the systemic issues involved suggest that the management of patients in a renal medicine inpatient unit requires a dedicated attachment of a consultant psychiatrist-led, multidisciplinary, liaison psychiatry team which is well trained in psychodynamic issues and is comfortable with the complexity of biological issues which arise. The data provide a reliable basis for comparison with other services.

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 Prevalence of Psychiatric Morbidities in Acute Coronary Heart Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Saeed Shoja shafti
Keyword(s):  
Dysthymic Disorder ◽  
Cardiac Events ◽  
Liaison Psychiatry ◽  
Chronic Group ◽  
Acute Group ◽  
Number Of Patients ◽  
Significant Difference ◽  
High Prevalence ◽  
Consultation Liaison Psychiatry ◽  
Psychiatric Problems

Introduction. Psychiatric problems and stresses may deteriorate the prognosis of patients with IHD. So evaluating their frequency possibly will promote our perspective regarding their vital importance in the field of consultation-liaison psychiatry. Method and Materials. One hundred and one (101) patients with IHD were interviewed in CCU of a general hospital by a psychiatrist to find whether there was any relationship between cardiac events and psychiatric problems or stresses. Results. Cardiac events were significantly more prevalent among patients with both psychiatric problems and biological risk factors (P<0.05). Also, the number of patients suffering from psychiatric problems was significantly more than cases without that (P<0.05). There was a significant difference between male and female patients regarding the type of stress (P<0.01). 79% of total stresses were experienced by patients who had as well psychiatric problems (P<0.0001). In addition, there was significantly more dysthymic disorder in the acute group of patients in comparison with major or minor depressive disorder in the chronic group (P<0.001). Conclusion. The high prevalence of psychiatric problems and psychosocial stresses among patients with IHD deserves sufficient attention by clinicians for detection, monitoring, and management of them.

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.

Consultation–Liaison Psychiatry Activities in a Renal Transplant Unit

1979 ◽  
Vol 32 (1-4) ◽  
pp. 157-163 ◽  
Author(s):  
Hellmuth Freyberger ◽  
Marianne Ludwig ◽  
Marlene Mangels ◽  
Peter Neuhaus
Keyword(s):  
Renal Transplant ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry

Consultation liaison psychiatry in Talavera's hospital during the year 2014

2016 ◽  
Vol 33 (S1) ◽  
pp. S394-S394
Author(s):  
M. Palomo Monge ◽  
D.C. Sandra ◽  
A.L. Maria Fernanda ◽  
G.M. David ◽  
T.G. Maria Fernanda ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Psychiatric Disorders ◽  
Descriptive Study ◽  
Liaison Psychiatry ◽  
Consultation Service ◽  
Cross Sectional ◽  
Consultation Liaison Psychiatry ◽  
Competing Interest

IntroductionAnalyze the number of interdepartmental consultations carried out at Department of Psychiatry, Hospital Nuestra Señora del Prado from other areas of hospitalization during 2014.ObjectivesThe goal is to evaluate the prevalence of psychiatric disorders in patients who are hospitalized for other reasons, and which services are needed the most.MethodsRetrospective cross-sectional descriptive study. A record of consultations carried out by the psychiatry service in 2014 was collected. The data were analyzed according to the origin of the consultation service, the month when it was performed and the sex of the patient. The monthly percentage of interconsultations and the percentage represented by each interconsultation service were calculated. They classified according to sex.ResultsIn 2014, 211 interconsultations were carried out, 104 men and 86 women. Surgery 16, 11%, pneumology 13, 74%, internal medicine 12, 32%, traumatology 8, 06%, digestive 7, 11%), I.C.U. 6, 64%, cardiology 6, 16%, hematology 5, 69%, oncology 5, 21%, pediatrics 4, 27%, gynecology 2, 84%, emergency 1, 90%, palliative1, 90%, endocrinology 1, 42%, urology 1, 42, nephrology 0, 95%, E.N.T. 0, 95%, obstetrics 0, 47%, dermatology 0%, ophthalmology 0%, rheumatology 0%. January 12, 8%, February 13%, March 9, 5%, April 6, 2%, May 5, 7%, June 8, 1%, July 6, 2%, August 4, 3%, September 8, 1%, October 12%, November 7, 6%, December 6, 2%.ConclusionsMost of the interconsultations were carried out in January, February and October. However, August was the least busy month. The busiest service was the Surgery service, followed by the Pneumology and Internal Medicine one. There were no interconsultations of the Ophthalmology, Rheumatology and Dermatology services. The consults were in demand mainly by men rather than women.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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