Psychiatric acute consultation in general hospital

Abstract

Objective To explore the characteristics of psychiatric acute consultation in general hospital.Methods During 3 years (2009.07..01-2012.06.30),2789 referrals of psychiatric consultations were enrolled,among which 249 referrals were acute consultations,while others were common consultations as control group.The demographic characteristics,reasons for referral,referral department,psychiatric diagnosis according to the International Statistical Classification of Diseases 10th Revision,management were analyzed.Results In acute consultations,the rate of male patients (51.1％) was higher than that in common consultations.The age range of patient in the two groups was similar.The rates of acute consultation in the referrals from emergency department (35.2％),intensive care unit (34.8％) and surgical department (15.6％) were higher than that from nonsurgical department (4.2％).The major reason of acute consultation was psychotic symptoms (41.4％) followed by emotional symptoms (30.1％) which was the major reason of common consultation.The rates of psychotic symptoms, suicide-related issues (8.0％), uncooperative behavior (14.8％) as referral reasons were higher in acute consultation group than in common consultation group.The most common psychiatric diagnosis among acute consultations was organic mental disorder (37.8％).Medication was given in 199 out of 249 acute consultations.The rate of medication was higher in acute consultation group,while the rate of psychotherapy was higher in common consultation group.Antipsychotics were the most common medications given in acute consultations.Conclusions Psychotic symptom is the most common referral reason for psychiatric acute consultation.The doctors have to pay attention to identification,evaluation and management of suicide risk.Setting up triage model can optimize the psychiatric consultation management. Key words: General hospital; Consultation-liaison psychiatry; Acute consultation; Common consultation