Consultation-liaison psychiatry in newly established general hospital psychiatry unit: Scope and suggestions

Abstract

Background: Consultation-liaison (C-L) psychiatry is the subspecialty of psychiatry dealing with mental health disorders in nonpsychiatric settings. The ubiquity of mental health problems has increased the need for such a service to exist in general hospital psychiatric units, as many psychiatric patients report to a different specialty of medicine for the first time. This study aims to evaluate the utilization of psychiatry C-L services by nonpsychiatric inpatient units in a general hospital psychiatry unit taking into consideration the paucity of data for understanding the trends and improving service provision in the future. Materials and Methods: A retrospective chart review of all inpatient referrals received by the psychiatry department from July 2015 to February 2017 was conducted. The sociodemographic profile, source of referral, reason for referral, and psychiatric diagnosis using the International Statistical Classification of Diseases-10 were analyzed using descriptive statistical methods. Results: A total of 605 patients were referred, which comprised 0.86% of total indoor admissions. Maximum number of consultations was sought from internal medicine. “Unexplained physical symptoms” was the most common reason for referral (35%). Consequently, neurotic, stress-related, and somatoform disorder (25.5%) was the most common psychiatric diagnosis followed by mood disorder (19.8%). Conclusion: Poor and variable referral rate from various departments highlights the increasing need to sensitize all clinicians regarding psychiatric comorbidity. There is a need to explore factors that would result in increasing referral rates and making psychiatric consultation services effective and efficient.