Grover Sandeep, Sahoo Swapnajeet, Aggarwal Shivali, Dhiman Shallu, Chakrabarti Subho, Avasthi Ajit
Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychiatry. 2017 Apr-Jun;59(2):170-175. doi: 10.4103/psychiatry.IndianJPsychiatry_305_16.
Very few studies have evaluated the reasons for referral to consultation-liaison (CL) psychiatry teams.
This study aimed to evaluate the psychiatric morbidity pattern, reasons for referral and diagnostic concordance between physicians/surgeons and the CL psychiatry team.
Two hundred and nineteen psychiatric referrals made to the CL psychiatry team were assessed for reason for referral and diagnostic concordance in terms of reason of referral and psychiatric diagnosis made by the CL psychiatry team.
In 57% of cases, a specific psychiatric diagnosis was mentioned by the physician/surgeon. The most common specific psychiatric diagnoses considered by the physician/surgeon included depression, substance abuse, and delirium. Most common psychiatric diagnosis made by the CL psychiatric services was delirium followed by depressive disorders. Diagnostic concordance between physician/surgeon and psychiatrist was low (κ < 0.3) for depressive disorders and delirium and better for the diagnosis of substance dependence (κ = 0.678) and suicidality (κ = 0.655).
The present study suggests that delirium is the most common diagnosis in referrals made to CL psychiatry team, and there is poor concordance between the psychiatric diagnosis considered by the physician/surgeon and the psychiatrist for delirium and depression; however, the concordance rates for substance dependence and suicidal behavior are acceptable.
极少有研究评估转诊至会诊-联络(CL)精神科团队的原因。
本研究旨在评估精神疾病发病模式、转诊原因以及内科医生/外科医生与CL精神科团队之间的诊断一致性。
对转诊至CL精神科团队的219例精神科病例进行评估,分析转诊原因以及CL精神科团队在转诊原因和精神科诊断方面的诊断一致性。
在57%的病例中,内科医生/外科医生提到了特定的精神科诊断。内科医生/外科医生考虑的最常见的特定精神科诊断包括抑郁症、物质滥用和谵妄。CL精神科服务做出的最常见精神科诊断是谵妄,其次是抑郁症。内科医生/外科医生与精神科医生之间在抑郁症和谵妄方面的诊断一致性较低(κ<0.3),而在物质依赖(κ=0.678)和自杀倾向(κ=0.655)的诊断方面一致性较好。
本研究表明,谵妄是转诊至CL精神科团队的病例中最常见的诊断,内科医生/外科医生与精神科医生在谵妄和抑郁症的诊断方面一致性较差;然而,物质依赖和自杀行为的一致性率是可以接受的。