Mudgal Varchasvi, Rastogi Pali, Niranjan Vijay, Razdan Ramghulam
Psychiatry, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India.
Gen Psychiatr. 2020 Jun 18;33(4):e100177. doi: 10.1136/gpsych-2019-100177. eCollection 2020.
Consultation liaison psychiatry (CLP) as a subspecialty is defined as the area of clinical psychiatry that encompasses clinical understanding, teaching and research activities of psychiatrists and allied health professionals in the non-psychiatric divisions of a general hospital. Psychiatric comorbidity of inpatients in tertiary care hospitals is huge. However, the amount of research in India in the field of consultation liaison is strikingly low.
To investigate the sociodemographic profile and psychiatric and physical subtypes of illness in patients admitted in other departments and referred to psychiatry department.
The study population comprised all consecutive inpatients referred for psychiatric consultation from other departments of a multispecialty tertiary care teaching hospital over 3 months. In a semistructured proforma, sociodemographic profile, referring departments, reasons for referral, referral rate, psychiatric diagnosis and physical illness diagnosis were recorded and analysed using descriptive statistics.
172 patients were included and assessed after referral from various departments, of which 56.4% were male and 43.6% were female. The mean age was about 33.95 years, with majority of the patients in the 21-30 years age group. The referral rate was 1.1%. The maximum referrals were from the medicine department, with abnormal behaviour (26.2%) being the most common reason for referral, followed by alleged suicide attempt or self-harm (24.4%), anxiety (10.5%), substance use (10%) and disorientation (7.6%). The most common psychiatric disorder among patients was depressive disorder (24.4%), followed by substance use disorder (19.7%), schizophrenia and psychotic disorder (9.3%), and stress and trauma-related disorder (8.1%).
There are very few psychiatry referrals and an alarmingly low referral rate, given the psychiatric morbidities in the medical setting. Psychiatry training should have more weightage across different medical specialties and liaison activities between psychiatry and other disciplines should be augmented, which can lead to a better understanding of psychiatric symptomatology, early symptom recognition, swift referral and ensuring follow-up, which, in turn, would be key to improving CLP services.
会诊联络精神病学（CLP）作为一个亚专业，被定义为临床精神病学的一个领域，涵盖了综合医院非精神科部门的精神科医生及相关健康专业人员的临床理解、教学和研究活动。三级护理医院住院患者的精神疾病共病情况严重。然而，印度在会诊联络领域的研究数量极低。
调查转入精神科的其他科室住院患者的社会人口学特征以及精神和躯体疾病亚型。
研究对象包括一家多专科三级护理教学医院其他科室连续3个月转诊至精神科进行会诊的所有住院患者。使用半结构化表格记录社会人口学特征、转诊科室、转诊原因、转诊率、精神科诊断和躯体疾病诊断，并采用描述性统计方法进行分析。
共纳入172例经各科室转诊并评估的患者，其中男性占56.4%，女性占43.6%。平均年龄约为33.95岁，大多数患者年龄在21 - 30岁组。转诊率为1.1%。转诊最多的是内科，异常行为（26.2%）是最常见的转诊原因，其次是疑似自杀企图或自我伤害（24.4%）、焦虑（10.5%）、物质使用（10%）和定向障碍（7.6%）。患者中最常见的精神障碍是抑郁症（24.4%），其次是物质使用障碍（19.7%）、精神分裂症和精神障碍（9.3%）以及应激和创伤相关障碍（8.1%）。
鉴于医疗环境中的精神疾病发病率，精神科会诊转诊极少，转诊率低得惊人。精神科培训应在不同医学专科中占更大比重，精神科与其他学科之间的联络活动应加强，这有助于更好地理解精神症状学、早期症状识别、迅速转诊并确保后续跟进，而这反过来将是改善会诊联络精神病学服务的关键。
