scholarly journals Stability of Psychiatric Diagnoses in Candidates to Liver Transplantation Referred to a Consultation-Liaison Psychiatry Service

2019 ◽  
Vol 8 (6) ◽  
pp. 800 ◽  
Author(s):  
Giorgio Mattei ◽  
Maria Moscara ◽  
Jessica Balducci ◽  
Silvia Cavana ◽  
Melissa Cherubini ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Depressive Disorder ◽  
Psychiatric Service ◽  
Stability Index ◽  
University Hospital ◽  
Psychiatric Diagnoses ◽  
Liaison Psychiatry ◽  
Diagnostic Stability ◽  
Consultation Liaison Psychiatry ◽  
The Stability

Objective: To investigate the stability over time of the psychiatric diagnoses among candidates to liver transplantation referred to a consultation-liaison psychiatric service. Method: Descriptive study, carried out at the Consultation-Liaison Psychiatry Service (CLPS) placed at the Modena (Italy) General University Hospital. All patients waiting for liver transplantation and repeatedly referred to the CLPS were enrolled. The observation period was from 1 January 2008 to 31 December 2013. Pearson’s coefficients were calculated to measure diagnostic stability (index referral vs. last referral). Results: One hundred patients were assessed (males 67%; mean age 53 ± 7 years old). The mean number of referrals for patients was 3 ± 2. The stability rate of psychiatric diagnosis was 64%. The following diagnoses or conditions were all significantly stable (i.e., all featured by r > 0.5 and p < 0.05): Adjustment disorder, depressive disorder, comorbid anxiety/depressive disorder, substance use disorder (including alcohol), absence of any disorder, and presence of any disorder. Conclusions: The good level of diagnostic stability displayed in the sample may be a function of the clinical and organizational “style” of the CLPS, namely the focus on identifying the prevailing personality traits, defensive mechanisms, and relational patterns.

scholarly journals Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

2020 ◽  
Vol 17 (20) ◽  
pp. 7389
Author(s):  
Silvia Ferrari ◽  
Giorgio Mattei ◽  
Mattia Marchi ◽  
Gian Maria Galeazzi ◽  
Luca Pingani
Keyword(s):  
Older Patients ◽  
Clinical Training ◽  
University Hospital ◽  
Liaison Psychiatry ◽  
Female Ratio ◽  
Research Activities ◽  
Male Female Ratio ◽  
Health Related ◽  
Consultation Liaison Psychiatry ◽  
Management Changes

There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.

scholarly journals Psychiatric presentation of patients with acute SARS-CoV-2 infection: a retrospective review of 50 consecutive patients seen by a consultation-liaison psychiatry team

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Yousaf Iqbal ◽  
Majid Ali Al Abdulla ◽  
Sultan Albrahim ◽  
Javed Latoo ◽  
Rajeev Kumar ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Psychiatric Morbidity ◽  
Physical Symptoms ◽  
Service Planning ◽  
Psychiatric Diagnoses ◽  
Psychiatric History ◽  
Upper Respiratory Tract ◽  
Liaison Psychiatry ◽  
Wide Range ◽  
Consultation Liaison Psychiatry

Background Reports of psychiatric morbidity associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection tend to be limited by geography and patients’ clinical status. Representative samples are needed to inform service planning and research. Aims To describe the psychiatric morbidity associated with SARS-CoV-2 infection (confirmed by real-time polymerase chain reaction) in referrals to a consultation-liaison psychiatry service in Qatar. Method Retrospective review of 50 consecutive referrals. Results Most patients were male. Median age was 39.5 years. Thirty-one patients were symptomatic (upper respiratory tract symptoms or pneumonia) for coronavirus disease 2019 (COVID-19) and 19 were asymptomatic (no characteristic physical symptoms of COVID-19 infection). Seventeen patients (34%) had a past psychiatric history including eight with bipolar I disorder or psychosis, all of whom relapsed. Thirty patients (60%) had physical comorbidity. The principal psychiatric diagnoses made by the consultation-liaison team were delirium (n = 13), psychosis (n = 9), acute stress reaction (n = 8), anxiety disorder (n = 8), depression (n = 8) and mania (n = 8). Delirium was confined to the COVID-19 symptomatic group (the exception being one asymptomatic patient with concurrent physical illness). The other psychiatric diagnoses spanned the symptomatic and asymptomatic patients with COVID. One patient with COVID-19 pneumonia experienced an ischaemic stroke. Approximately half the patients with mania and psychosis had no past psychiatric history. Three patients self-harmed. The commonest psychiatric symptoms were sleep disturbance (70%), anxiety (64%), agitation (50%), depressed mood (42%) and irritability (36%). Conclusions A wide range of psychiatric morbidity is associated with SARS-CoV-2 infection and is seen in symptomatic and asymptomatic individuals. Cases of psychosis and mania represented relapses in people with schizophrenia and bipolar disorder and also new onset cases.

scholarly journals Accuracy of Psychiatric Diagnoses in Consultation Liaison Psychiatry

2008 ◽  
Vol 3 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Abdulqader Maqbul Aljarad ◽  
Fahad Dakhil Al Osaimi ◽  
Yaser Rashid Al Huthail
Keyword(s):  
Psychiatric Diagnoses ◽  
Liaison Psychiatry ◽  
Consultation Liaison Psychiatry

Association between the timing of consultation-liaison psychiatry interventions and the length of stay in general hospital

2019 ◽  
pp. 1-6 ◽  
Author(s):  
Hélène Vulser ◽  
Victoire Vinant ◽  
Victoria Lanvin ◽  
Gilles Chatellier ◽  
Frédéric Limosin ◽  
...  
Keyword(s):  
General Hospital ◽  
Disease Severity ◽  
Psychotic Disorders ◽  
Linear Models ◽  
Large Population ◽  
University Hospital ◽  
Liaison Psychiatry ◽  
Lengths Of Stay ◽  
Health Related ◽  
Consultation Liaison Psychiatry

Background Psychiatric comorbidities are frequent in patients admitted in general hospital and are associated with greater lengths of stay (LOS). Early consultation-liaison psychiatry (CLP) interventions may reduce the LOS but previous studies were underpowered to allow subgroup analyses and have generally not considered the severity of the condition for which patients were admitted (‘disease severity’). Aims To investigate the association between the timing of CLP interventions and LOS in a general hospital. Method We retrospectively included 4500 consecutive patients admitted in non-psychiatric wards of a university hospital between 2008 and 2016 who had a first CLP intervention. We used general linear models to examine the association between the referral time, defined as log(days before the consultation)/log(LOS), and log(LOS), adjusting for age, gender, year of admission, place of residence, main psychiatric diagnosis, admission to the intensive care unit (ICU), main physical condition and disease severity. Results Referral time was associated with log(LOS) (β = 0.31; P <0.001), notably for older patients (β = 0.43; P <0.001) and those admitted to the ICU (β = 0.50; P <0.001), but not for those with psychotic disorders (β = −0.20; P = 0.10). The association was confirmed when considering the expected LOS for each patient. For instance, for an expected LOS of 10 days, a CLP intervention on day 3 compared with day 6 was associated with a reduction of the actual LOS of 2.4 days. Conclusions Earlier CLP interventions were associated with a clinically significant shorter LOS in a large population even after adjusting for disease severity. Early CLP interventions may have benefits for both patients and health-related costs.

scholarly journals Audit of child and adolescent psychiatry in a teaching hospital in Nigeria: Prevalence, pattern and implication for improved services

2010 ◽  
Vol 16 (1) ◽  
pp. 20 ◽  
Author(s):  
M F Tunde-Ayinmode
Keyword(s):  
Teaching Hospital ◽  
Psychiatric Service ◽  
Child And Adolescent ◽  
Child And Adolescent Psychiatry ◽  
Liaison Psychiatry ◽  
Seizure Disorders ◽  
Child Psychiatric ◽  
Consultation Liaison Psychiatry ◽  
The University ◽  
Age Range

<p><strong>Objective</strong> . This study aimed to identify the socio-demographic characteristics, pattern of psychiatric disorders and management of children and adolescents before the setting up of a dedicated child and adolescent unit at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.</p><p><strong>Method</strong> . A retrospective study, carried out at the Department of Behavioural Sciences of the hospital. <strong></strong></p><p><strong>Results</strong> . The age range of the 94 children seen was 7 - 19 years, with a mean of 16.38 years (standard deviation 2.49); 82% were aged 14 - 19 years and 17% 7 - 13 years, while only 1 child was under 7 years old. The majority of the children lived with their parents in monogamous families with 5 or more children. The majority of the parents were educated and gainfully employed. The major diagnoses were schizophrenia (50%), delirium (15%) and seizure disorders (9%). Of the patients 64% were managed as outpatients and 36% as inpatients. Drug therapy was involved in the majority of cases, and the most frequently prescribed medication was haloperidol, atypical antipsychotics such as risperidone being used in only 8% of cases. Most of the patients were referred from the primary care- associated departments of the hospital, i.e. the general outpatient department (40%) and the internal medicine and paediatrics departments (29%). Referrals from welfare, judicial and educational institutions were uncommon (3%). <strong></strong></p><p><strong>Conclusion .</strong> The pattern of patient presentation and management had not changed to any great extent over the past two decades. The introduction of a child and adolescent psychiatric unit is expected to improve consultation/liaison psychiatry and also child psychiatric service delivery and research. Understanding of the prevalence and pattern of presentation of mental disorders and their management is also expected to help improve the strategic planning and organisation of the new clinic.</p>

scholarly journals Diagnostic Stability of Major Depressive Disorder in hospitalized patients in a University Hospital: a Brief Report

2021 ◽  
Vol 5 (3) ◽  
pp. 141-144
Author(s):  
Enrique De Doménico ◽  
João Mauricio Castaldelli-Maia ◽  
Antonio Ventriglio ◽  
Julio Torales
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Hospital Admission ◽  
Mentally Ill ◽  
University Hospital ◽  
Major Depressive ◽  
Cross Sectional ◽  
Diagnostic Stability ◽  
Probabilistic Sampling ◽  
National University

Introduction: There may be a discordance between diagnoses at admission and discharge of mentally ill patients with major issues regarding their diagnostic stability. The objective of this brief report was to determine the diagnostic stability of major depressive disorder at patients’ discharge and if the diagnosis of their hospital admission had been retained. Methodology: This was a pilot, descriptive, cross-sectional, and retrospective observational study. A non-probabilistic sampling of consecutive cases was used.  We reviewed the medical records, at admission and discharge, of patients with an initial diagnosis of major depressive disorder, hospitalized in the Department of Psychiatry of the ‘Hospital de Clínicas’ of the National University of Asunción, Paraguay, during the months of October to December 2020. Results: Fifty-three patients with a diagnosis of major depression on their hospital admission were included in the study (mean age = 35.7 ± 16.5 years). 79.2 % were women, 52.8 % were single, and 37.7 % were from the Central province of Paraguay. The most frequent diagnosis at discharge was borderline personality disorder, in 35.8% of cases. Major depressive disorder was confirmed in 15.1% of cases. No significant relationship was found between any discharge diagnosis and sociodemographic data. Conclusion: The results of this study, although preliminary, described the trajectories of diagnoses in the Psychiatry Department of a University hospital, but confirmatory studies are needed.

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