scholarly journals Training in liaison psychiatry

1993 ◽  
Vol 17 (2) ◽  
pp. 95-96 ◽  
Author(s):  
A. O. House ◽  
F. Creed

It is generally agreed that training in liaison psychiatry should be available at SHO/registrar grade, but the College's guidelines are not specific about what it might entail. As a result it is difficult for approval visitors to decide whether a particular post on a rotational training scheme truly provides liaison experience. At times so-called “liaison experience” amounts to no more than participation in a duty-rota for visiting a general hospital to undertake the assessment of cases of deliberate self-harm.

1987 ◽  
Vol 150 (1) ◽  
pp. 83-87 ◽  
Author(s):  
A. Brown ◽  
A. F. Cooper

A retrospective study of psychiatric referrals from a general hospital inpatient population was carried out for three separate years, 1973, 1976 and 1979. Reorganisation of the liaison service to the responsibility of one consultant team was associated with changes in referral rate and disposal. In particular, there was a significant increase in the referral rate of patients from medical and surgical wards who were not involved in acts of deliberate self-harm.


1994 ◽  
Vol 39 (5) ◽  
pp. 141-144 ◽  
Author(s):  
D.J. Hall

Referrals to a liaison psychiatry service, based in a District General Hospital, were studied over a six month period. 190 [89%] of the 214 referrals were for assessment following an episode of deliberate self harm. An excess of these referrals were male [57%] and a large proportion particularly of the males [36%] were diagnosed as having a significant alcohol problem. Many were felt to have no significant psychiatric problem [31%], and a large proportion were discharged with no psychiatric follow-up [28%]. Patterns of diagnosis and disposal differed between the sexes. Referring junior medical staff when asked to give their opinions on the likely management and overall need for psychiatric referral of patients were found to reach reasonable agreement with the assessing psychiatrist, even without prior training, and to be more cautious in their assessment. In many centres the trend is towards selective referral of deliberate self harm patients, and this appears a safe and appropriate development which can be achieved without intensive training or major alterations to working patterns, and which will result in modest but important reductions in inappropriate referrals.


Crisis ◽  
2004 ◽  
Vol 25 (4) ◽  
pp. 183-186 ◽  
Author(s):  
Rachel Crowder ◽  
Rohan Van Der Putt ◽  
Ceri-Anne Ashby ◽  
Andrew Blewett

Abstract: Deliberate self-harm patients who leave the acute hospital environment before the completion of psychiatric assessment have an increased risk of subsequent self-harm. We considered the available data on 50 premature self-discharges identified prospectively in a general hospital with a well-developed integrated-care pathway for self-harm patients, and compared them to a control group. The self-discharge group was found to be more likely to have attempted self-poisoning without alcohol intoxication or other forms or combinations of self-harm, and an absence of identifiable previous self-harm or prior contact with local specialist psychiatric services. The two groups showed no difference in age, sex, or area of residence based on community mental health team sectors. It is proposed that these findings indicate hypotheses for further studies of why people leave the hospital without adequate assessment, and how service design could be improved in order to help them.


2000 ◽  
Vol 177 (5) ◽  
pp. 463-466 ◽  
Author(s):  
Keith Hawton ◽  
Louise Harriss ◽  
Louis Appleby ◽  
Edmund Juszczak ◽  
Sue Simkin ◽  
...  

BackgroundThe death of the Princess of Wales in 1997 was followed by widespread public mourning. Such major events may influence suicidal behaviour.AimsTo assess the impact of the Princess's death on suicide and deliberate self-harm (DSH).MethodAnalysis, using Poisson regression, of the number of suicides and open verdicts (suicides’) in England and Wales following the Princess's death compared to the 3 months beforehand, and the equivalent periods in 1992–1996. Similar analysis on DSH presentations to a general hospital.ResultsSuicides increased during the month following the Princess's funeral (+ 17.4%). This was particularly marked in females (+33.7%), especially those aged 25–44 years (+45.1%). Suicides did not fall in the week between the death and the funeral. Presentations for DSH increased significantly during the week following the death (+44.3%), especially in females (+65.1%). Examination of case notes suggested that the influence of the death was largely through amplification of personal losses or exacerbation of existing distress.ConclusionsThe death of a major public figure can influence rates of suicidal behaviour. For DSH, the impact may be immediate, but for suicide it may be delayed.


2001 ◽  
Vol 178 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Camilla Haw ◽  
Keith Hawton ◽  
Kelly Houston ◽  
Ellen Townsend

BackgroundPrevious UK studies have reported much lower rates of psychiatric and personality disorder in those who attempt suicide than in those who die by suicide.AimsTo determine the nature and prevalence of psychiatric and personality disorders in deliberate self-harm (DSH) patients.MethodA representative sample of 150 DSH patients who presented to a general hospital were assessed using a structured clinical interview and a standardised instrument. Follow-up interviews were completed for 118 patients approximately 12–16 months later.ResultsICD–10 psychiatric disorders were diagnosed in 138 patients (92.0%), with comorbidity of psychiatric disorders in 46.7%. The most common diagnosis was affective disorder (72.0%). Personality disorder was identified in 45.9% of patients interviewed at follow-up. Comorbidity of psychiatric and personality disorder was present in 44.1%.ConclusionsPsychiatric and personality disorders, and their comorbidity, are common in DSH patients. This has important implications for assessment and management.


1996 ◽  
Vol 23 (2) ◽  
pp. 246-252 ◽  
Author(s):  
K. Wylie ◽  
A. House ◽  
D. Storer ◽  
D. Raistrick ◽  
M. Henderson

1996 ◽  
Vol 20 (8) ◽  
pp. 466-469
Author(s):  
Margaret Semple ◽  
David Brown ◽  
Elizabeth Irvine

Of 299 referrals to the Dundee general psychiatry liaison service over a six month period, deliberate self-harm (DSH) was the reason in 83%. An overdose was used in 94%, and alcohol misuse occurred in 56% of DSH episodes. Fifty-two per cent of referrals were followed up by the general psychiatry service; 31% of these were admitted directly to a psychiatric ward, 10% on a compulsory basis. At follow-up, 23% remained in contact with the Dundee psychiatric service. Twenty-three per cent of all patients referred to the Area Alcohol Service (AAS) were in contact with it six months later. Clearly, liaison psychiatry has a role in detection and management of significant mental disorder.


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