JNMA J Nepal Med Assoc. 2013 Jan-Mar;52(189):238-44.
Psychiatric morbidity patterns in referred inpatients of other specialties.
Risal A1, Sharma PP. Author information Abstract INTRODUCTION: Consultation-liaison psychiatry is an upcoming field dealing with interdepartmental collaboration heading into multidisciplinary and holistic care. In general hospital setting, psychiatrists need to be involved in evaluation of patients referred from other specialties. This study analyzed the psychiatric morbidity among the inpatients referred to Psychiatry Department from different wards in a Tertiary care University Teaching Hospital. METHODS: Total 385 subjects were referred to the Department of Psychiatry from different wards during a period of one year. Each of them underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Psychiatric diagnosis was considered as per International Classification of Disease-10 criteria. RESULTS: The mean age of the subjects evaluated was 37.26 (1.86); most of them were females 216 (56.4%), married 287 (74.5%), and homemaker 159 (41.3%). Maximum 271 (70.4%) referral was from Medical ward, and most of them 292 (75.8%) were admitted in general bed. The most common medical diagnosis was self-poisoning 115 (30.6%) followed by alcoholic liver disease 49 (12.7%); while the commonest 123 (31.9%) psychiatric diagnosis was depression (including Dysthymia and Adjustment disorder). Depression remained the commonest diagnosis among those referred from medical ward 131 (34.7%); while anxiety was mostly found in the emergency referral 94 (24.5%). Significant Correlation (P <0.05) was seen between the source of referral and Psychiatric diagnosis. CONCLUSIONS: Psychiatric consultation was sought mostly by medical ward that had maximum number of patients presenting with self-poisoning. The commonest diagnosis seen in the referred in-patients was depression and anxiety disorder.
Javed Akhtar, Saeed Farooq, Ashfaq Ali.
Psychiatric referrals in a multidisciplinary hospital J Postgrad Med Inst Oct - Dec 2004;18(4):626-30. Department of Psychiatry, DHQ Hospital, Bannu & Postgraduate Medical Institute, Lay Reading Hospital, Peshawar Objective: To evaluate the pattern of psychiatric referrals and to study the various diagnostic categories associated with physical disorders. Material and Methods: The study was conducted at Khyber Teaching Hospital Peshawar over a period about three months. There were 100 psychiatric referrals during the study period. Patients were assessed on a structured proforma and psychiatric morbidity was classified according to ICD-10. Results: Out of 100 patients, females (62%) outnumbered the males. The most common reasons for the referral were unexplained physical symptoms (40%) and disruptive behavior (15%). Depression was the most common diagnosis made (40%). More than two third of the patients (72%) were referred from medical units. 8% had no psychiatric morbidity. Conclusion: There is a need for greater dialogue and interactions between referring doctor and consultant psychiatrists
Mazhar Malik, Nadeem Abbas, Nadia Azad.
Psychiatric co-morbidity in medical and surgical in-patients, referred for Psychiatric Consultation J Rawal Med Coll Jun 2008;12(1):19-24. Fauji Foundation Hospital, Rawalpindi. To assess by Liaison Psychiatry the pattern of psychiatric co-morbidity in ref rred medical and surgical in-patients in a tertiary care hospital. Methods: This was a descriptive study, conducted at Department of Psychiatry, out-patien services in Fauji Foundation Hospital, Rawalpindi. One hundred consecutive hospitalized paients referred to Department of Psychiatry from Medical and Surgical Units of Fauji Foundation Hospital were enrolled in the study during a period of seven months. A semi structured proforma was used for collection of demographic data and detailed information regarding reasons of psychiatric referral along with current medical and surgical complaints. Results: Mean age of the sample was 39.9 years, 77% of the patients were female and majority of the patients, 62% were married. All the patients belonged to either poor class (61%) or lower middle class (39%). Professional categories showed house wives (54%) comprising the major group and 25% were students. Majority of the patients, 56% were referred from medical departments and the main reason for referral was medically unexplained physical symptoms (36%) of one hundred consultations. General Health Questionnaire 12 (GHQ-12) screened 89% of cases with psychiatric co-morbidity as compared to 11% non cases without psychiatric symptomatology. Majority (51%) of the patients had diagnosis of depressive episode, mild moderate or severe and 19% of the patients had dissociative (conversion) disorder as the second commonest diagnosis. Conclusions: There is generally a low referral rate despite significant psychiatric morbidity among medical and surgical in-patients. Further studies should be conducted in the field of liaison psychiatry to address other variables such as length
of hospital stay, use of laboratory investigations and pattern of prescription
medicines.
Majid A Abidi, Amin A Gadit.
Liaison Psychiatry and referral rates among hospitalized patients J Coll Physicians Surg Pak May - May 2003;13(5):274-6. Department of Psychiatry, Hamdard university Hospital, Karachi Objective: The study was conducted to assess the psychiatric co-morbidity among general hospital patients and their rate of referrals. Design: A hospital based descriptive observational study. place and duration of study: The study was conducted in a private teaching hospital for a period of 6 months. Method: All admitted patients in different disciplines were assessed on a structured proforma supplemented by detailed psychiatric interview on positive cases. Morbidity patterns were assessed on the basis of ICD-10 classification. The total referral record was also maintained and compared with the data of morbidity and the number of referred cases. Results: Out of the total 487 patients seen, 180 patients were found to have psychiatric co-morbidity; depression outnumbered all psychiatric disorders followed by mixed anxiety depression and somatoform disorders. Married female formed the majority group and the vulnerable age was between 41 to 60 years. Large segment of patients belonged to the discipline of internal medicine with the lowest (12%) referral rate. Out of 121 patients, referred from department of psychiatry, 44% were seen by the department of medicine followed by the gynecology and other disciplines. Conclusion: There is generally a low referral rate despite significant mental health co-morbidity. Training is needed for non-psychiatrists and there is a need for development of consultation-liaison psychiatry services in hospitals.