scholarly journals Thirty years of in-patient consultation-liaison psychiatry at Guy's

1995 ◽  
Vol 19 (10) ◽  
pp. 631-634 ◽  
Author(s):  
Ben Lucas ◽  
Harry Doyle
Keyword(s):  
General Hospital ◽  
Patient Population ◽  
Substance Misuse ◽  
General Medicine ◽  
Psychiatric Services ◽  
Liaison Psychiatry ◽  
Planning Decisions ◽  
Unmet Demand ◽  
Consultation Liaison Psychiatry ◽  
Patient Consultation

In order to inform planning decisions, we aim to show how an in-patient consultation-liaison service has changed in 30 years. A year's referral of 175 inpatients was compared with surveys carried out in the same hospital 20 and 30 years previously. Neurosciences continue to refer the greatest percentage of its patients while general medicine produces the greatest demands on the service. There has been a large increase in substance misuse referrals, although other diagnostic groups have similar referral rates. Liaison service planners should be aware of the unmet demand for psychiatric services of the general hospital in-patient population.

Consultation-liaison psychiatry hits a midlife crisis

2002 ◽  
Vol 10 (3) ◽  
pp. 229-231
Author(s):  
Sandy Macleod
Keyword(s):  
General Hospital ◽  
Future Development ◽  
Psychiatric Services ◽  
New Work ◽  
Work Skills ◽  
Job Descriptions ◽  
Liaison Psychiatry ◽  
Midlife Crisis ◽  
Hospital Patients ◽  
Consultation Liaison Psychiatry

Objective: To illustrate the crisis affecting consultation-liaison psychiatry and its practitioners. Conclusions: There are several options that may be taken, or have already been taken, to secure a future for this psychiatric subspecialty. The need is apparent, and clinicians are willing, but funders are reluctant. The College's response has been critically important, but psychiatrists also need to develop new work skills and innovative job descriptions to ensure the continuation and future development of psychiatric services to general hospital 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 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

To the question of the role of consultation liaison psychiatry in diagnostics of psychosomatic disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S316
Author(s):  
V. Lebedeva ◽  
O. Pavlova ◽  
E. Yurovskaya
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Care ◽  
General Medicine ◽  
Gastrointestinal Diseases ◽  
Psychosomatic Disorders ◽  
Liaison Psychiatry ◽  
Psychosomatic Disorder ◽  
Primary Health ◽  
Consultation Liaison Psychiatry

BackgroundRelevance of consultation liaison psychiatry is conditioned by trend of steady rise of psychosomatic disorders and insufficient development of supplied forms and methods of medical care to patients with this pathology.AimTo study incidence rate of psychosomatic disorders in primary health care, to develop algorithm of medical care.Material and methodsA total of 2010 patients of the primary health care unit were examined. Methods used: clinical-psychopathological, clinical-dynamic, questionnaire screening, statistical (factor analysis).ResultsMental disorders, co-morbid with physical pathology, constituted 3.9% of the contingent with predominance of psychosomatic disorders–15.6 per 10,000 of the population. Respective from clinical-dynamic structure of psychosomatic disorders three groups of patients were distinguished: in need for consultation by a psychiatrist (22.9%); for course treatment by psychiatrist and subsequent observation by physicians (28%); and for systematic therapy and observation by psychiatrist (49.1%). Patients with psychosomatic disorders addressed general medicine network 1–2 years after onset of mental disorder and 6.4 ± 1.2 years after diagnostics of somatic pathology. Patients had predominantly cardiovascular (37.7%; P < 0.05), respiratory (20.5%), and gastrointestinal diseases (20.9%). Exacerbation of psychosomatic disorder was reliably interrelated with psychotraumatic situation and exacerbation of physical pathology. Introduced algorithm of psychiatric consultation consisted of:– evaluation of mental and physical status;– distinguishing the nosological groups;– choice of therapy;– formation of groups of observation (risk groups in need for course therapy, systematic therapy).ConclusionConsultation liaison psychiatry in general medical institution allows widening accessibility of psychiatric care and makes its provision more cost-effective.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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