Psychiatric consultations in obstetric inpatients.

Abstract

The purpose of this study was to investigate the psychiatric consultation condition in the obstetric ward with particular attention paid to the reasons for referral, psychiatric diagnoses and recommendations. This study was conducted in a medical center with 73 obstetric beds. All psychiatric consultations of obstetric inpatients during a 3-year period were included in this study. Data were derived from clinical charts and consultation records that included demographic data, reasons for referral, psychiatric diagnoses and treatment recommendations. Within the 3-year period, 28 patients were referred for psychiatric consultation, or 0.3% of the 9,972 obstetric admissions. The obstetric group represented 0.7% of all the psychiatric consultations. The most common reason for the referral was anxiety. Many obstetric problems, medical histories and psychiatric histories were found in these 28 patients. The most common diagnoses were depression or dysthymia, and schizophrenia. The diagnosis of organic mental disorders was rarely found. The vast majority of the psychiatric consultants were likely to recommend medication and psychological intervention. Even though there is a low psychiatric consultation rate among the obstetric inpatients, it does not mean that the prevalence rate of mental disorders is low in the obstetric patients. Psychiatric problems may be neglected or happen after patients are discharged. Organic mental disorders were rarely found in the obstetric patients which suggested a different pattern of mental disorders in the obstetric patients compared to other patients. The stress during child delivery needs further study for it may exacerbate or predispose a mental disorder. It is suggested that collaboration between obstetric staff and the consultation-liaison psychiatrists may provide better care for pregnant women patients.