Dua Devakshi, Grover Sandeep
Dept. Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Psychol Med. 2020 Nov 9;42(6):503-512. doi: 10.1177/0253717620964970. eCollection 2020 Nov.
This review aimed to evaluate all the published studies from India conducted in the consultation-liaison (CL) psychiatry setting to identify the diagnostic patterns and referral rates in this setting. Understanding the same can help in organizing the services and knowing the training needs.
A thorough literature search was done in August 2020 using different search engines (PubMed, Medknow, and Google Scholar). This was followed by an individual search of various Indian Psychiatry journals and a hand search of references in the available articles. Only those studies that described patients referred to psychiatry services from various specialties were included.
A total of 33 studies were selected for the review. More than half of them were published in the last 5 years. Studies have primarily reported psychiatric profile medically ill inpatients referred to CL psychiatry services, with the majority of the studies reporting the number of patients seen for the duration of at least 1 year. The referral rates for inpatients across different institutes have varied from 0.01% to 3.6%. The referral rates from emergency set-ups have varied from 1.42% to 5.4%, and in outpatients, from 0.06% to 7.17%. The most commonly diagnosed psychiatric disorders across different studies include depression; organic disorders, including delirium; substance use; intentional self-harm; and anxiety disorders.
A limited number of studies have reported the profile of patients seen in CL psychiatry setups. Available data from these studies suggest that referral rates to psychiatry services from other specialists are dismal. There is an urgent need to change the focus of psychiatry training at both undergraduate and the postgraduate levels to enhance the psychiatric knowledge of physicians to improve psychiatry referrals.
本综述旨在评估印度发表的所有在会诊-联络（CL）精神病学环境中开展的研究，以确定该环境中的诊断模式和转诊率。了解这些有助于组织服务并知晓培训需求。
2020年8月使用不同搜索引擎（PubMed、Medknow和谷歌学术）进行了全面的文献检索。随后对各种印度精神病学杂志进行了单独检索，并对现有文章中的参考文献进行了手工检索。仅纳入那些描述从各个专科转诊至精神病学服务的患者的研究。
共筛选出33项研究进行综述。其中一半以上是在过去5年发表的。研究主要报告了转诊至CL精神病学服务的内科住院患者的精神状况，大多数研究报告了观察至少1年的患者数量。不同机构的住院患者转诊率从0.01%至3.6%不等。急诊机构的转诊率从1.42%至5.4%不等，门诊患者的转诊率从0.06%至7.17%不等。不同研究中最常诊断的精神障碍包括抑郁症；器质性障碍，包括谵妄；物质使用；故意自伤；以及焦虑症。
仅有少数研究报告了CL精神病学机构中患者的情况。这些研究的现有数据表明，其他专科向精神病学服务的转诊率很低。迫切需要改变本科和研究生阶段精神病学培训的重点，以增强医生的精神病学知识，从而改善精神病学转诊。
