The Psychiatric Consultation Checklist: a structured form to improve the clarity of psychiatric consultation requests.

Medical specialty consultation is requested to obtain expert review of a patient's condition. The specialist usually receives a case synopsis with pertinent positives and negatives and a specific request for assistance. In contrast, the psychiatrist often gets a statement of diagnostic speculation (e.g., "depressed") with a request to "please evaluate." Classically, the psychiatric consultant begins with open-ended empathic questioning in an attempt to redefine the written consultation question. However, given the difficulty consultees have in forming questions, and increasing time limitations, a more structured approach to obtaining data might assist both the consultee (M.D. requesting assistance) and the consultant (psychiatrist). The Psychiatric Consultation Checklist (PCC) was devised to function as a paper "expert" questioning system to provide such assistance. In a pilot study, 10 administrations of the PCC took an average of 3.6 minutes. In comparison to consultations using standard forms, more data were supplied in several categories when the PCC was used, particularly regarding patient stressors, patient behaviors of concern, and consultee speculation on psychiatric diagnostic formulation. The PCC may be used in consultation research, for assessment and education of physicians in training (regarding psychiatric issues in the medical/surgical setting), and for general clinical consultation purposes.