உளவியல் & உளவியல் சிகிச்சை இதழ்
திறந்த அணுகல்
ஐ.எஸ்.எஸ்.என்: 2161-0487
ஐ.எஸ்.எஸ்.என்: 2161-0487
Sumeesha Brijesh Gajjar *
Background: High rates of psychiatric morbidity to the tune of 20%-65% are seen in medico-surgically ill patients but there is lack of research on concordance rates between psychiatrist and non-psychiatrist diagnoses of patients seen under consultation liaison patients, especially in general hospital settings.
Aim: To analyse pattern, reason of referrals, diagnostic and management concordance in patients with psychiatric morbidity in medico-surgical setting.
Materials and methods: 2476 consecutive referrals received during a period of 6 months (1.11.2022-31.04.2023) in Consultation Liaison (CL) services in department of psychiatry at a general hospital teaching institute were evaluated for reason of referral, psychiatric diagnosis and management given by the referring team vis-à-vis the CL team.
Results: Emergency and inpatient referral rate was 0.77% and 0.23%. Medicine and allied departments utilized Consultation-Liaison Psychiatry (CLP) services majorly (51.3%), 1/4th referrals were for psychiatric emergencies (24.7%). 41.1% of referrals were requested even before primary treating team zeroed on the body organ system involved followed by multisystem involvement in 18.96% referrals. Most common diagnosis made by CLP team was substance use disorder (25.44%), anxiety disorder (20.39%), depression (12.27%), delirium (9.3%) and 4.4% being nil psychiatry. Diagnostic concordance for major psychiatric diagnoses between medicine/surgery team and CLP team was fair in substance use disorders and anxiety disorders.
Conclusion: The study findings suggest that substance use disorder is the most common diagnosis made by CLP team with a fair diagnostic concordance between medicine/surgery team and CLP team for substance use disorder and anxiety disorders. Oral/parenteral psychotropic drugs were given in one third of cases even before CLP referral was initiated, resulting in higher frequency of side effects.