A descriptive study of pattern of psychiatric referrals and effect of psychiatric intervention in consultation-liaison set up in a tertiary care center

Abstract

Background: There is paucity of published data pertaining to consultation psychiatric services (CLP) in India. The data available reflect the under developed status of this subspecialty and need for strengthening the same. Research assessing the effectiveness of CLP services is the need of the hour. Objectives: Current study was taken up with the aim to study the pattern of psychiatric referrals in a teaching hospital, and to study the effect of intervention in CLP at the end of 4 weeks. Materials and Method: Sample was drawn from Indoor patients referred to department of psychiatry. Psychiatric diagnosis was made using International classification of diseases (CD-10 DCR). Clinical Global Impression severity (CGI-S) and Improvement (CGI-I) ware used to assess the effect of psychiatric intervention after 4 weeks. Results: about half of patients were referred from Internal Medicine, followed by Neurological sciences and surgical branches. About 30% of patients had no diagnosable psychiatric disorder. Common reasons for referral were evaluation of medical patient having co- morbid psychiatric symptoms, followed by assessment for intentional self-harm, past history of psychiatric illness, and substance use. There was a statistically significant reduction in the mean CGI-S scores after four weeks (t=16.356; p <0.001). Mean CGI-I score after 4 weeks was 1.89(±0.993). suggesting much improvement. Conclusion: Majority of patients are referred to Psychiatry from internal medicine and neurology. About one-third of the patient did not receive any Psychiatric diagnosis. Psychiatric intervention was found to be significantly beneficial.

Keywords

• Consultation-liaison psychiatry
• general hospital psychiatry
• psychiatry referrals