Impact of the COVID-19 Pandemic on Consultation-Liaison Psychiatry Services: An Exploratory Study From a Tertiary Care Center in North India.

Abstract

Objective: The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of psychiatric care, including consultation-liaison psychiatry (CLP) services. The objective of this study was to assess the demographic and clinical profiles of psychiatric referrals made to CLP services during the pandemic period and compare to data during the same timeframe from the previous year at a tertiary care center in North India.Methods: Data of patients referred for CLP consultation and seen by the CLP team in the medical-surgical wards wherein COVID-negative patients were admitted during the period of March 24, 2020, to October 11, 2020 (approximately 6.5 months, 201 days) were extracted from the CLP register (routinely maintained). These data were compared with that of the same timeframe from the previous year (March 24, 2019, to October 11, 2019).Results: During 2020, a total of 562 patients were referred to CLP services, in contrast to 1,005 patients referred in 2019, suggesting a 44% reduction in the number of referrals made to CLP services. During 2020, CLP referral patients more often had metabolic/endocrine disorders, myocardial infarction, and peripheral vascular diseases and less often had chronic obstructive pulmonary disease/asthma and autoimmune disorders compared to 2019. Also, the number of referrals made to CLP services in 2020 for treatment of new disorders declined significantly (P < .001), whereas referrals for abnormal behavior/uncooperativeness (P < .001), self-harm attempts (P = .007), and other reasons (evaluation for organ transplant, sleep disturbances; P = .029) increased significantly. Further, significantly higher percentages of patients were diagnosed with delirium (P = .03) and depressive disorders (P = .04) in 2020 compared to 2019.Conclusions: There was a significant increase in the number of psychiatric referrals for depressive disorders and self-harm attempts among admitted patients from medical-surgical units during the COVID period. These findings suggest that there is a need to modify CLP services to address the needs of patients referred to CLP services, especially during the COVID-19 pandemic.