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三级医院住院会诊-联络精神病学的应用模式

Pattern of Inpatient Consultation-liaison Psychiatry Utility in a Tertiary Care Hospital.

作者信息

Kumar Pankaj, Chaudhary Rupesh, Bhalla Jasleen Kaur, Gupta Aarti

机构信息

Department of Psychiatry, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

出版信息

Int J Appl Basic Med Res. 2023 Jan-Mar;13(1):34-39. doi: 10.4103/ijabmr.ijabmr_505_22. Epub 2023 Mar 27.

Abstract

BACKGROUND

Consultation-liaison psychiatry (C-LP) is an interface between physical and psychological health where the psychiatrists become a part of the medical team for a holistic approach in the treatment of the patient.

AIMS

Our study aimed to see the pattern and utility of C-LP services among inpatient referrals to the department of psychiatry.

SETTINGS AND DESIGN

This observational descriptive study recorded inpatient referrals to the department of psychiatry of a tertiary care hospital for 2 months.

SUBJECTS AND METHODS

The Mini-International Neuropsychiatric Interview (M. I. N. I.) was administered for identifying the comorbid psychiatric diagnoses.

RESULTS

Most of the received inpatient referrals were for male patients (73.7%) in the age group of 30-60 years (58%). Overall, the referral rate was significantly higher from the emergency department and intensive care units (ICU) (50%), followed by specialty (medicine and surgery) wards (20%) and super specialty (cardiology, gastroenterology, and oncology) wards (16%). Altered sensorium and restlessness were the most common reasons for referral (42%), followed by alcohol/drug withdrawal (21.6%), somatic complaints (7.3%), sadness of mood, disturbed sleep, and deliberate self-harm (6% each). Substance use disorders, including alcohol and opioid (32%), delirium (25%), and depression (19%), were among the most common psychiatric diagnoses seen in the referred patients.

CONCLUSIONS

The pattern observed indicates that most inpatient referrals for psychological evaluation are received for altered sensorium from emergency and ICU than wards. The utility of C-LP helps to understand the reciprocal interdependence between the medical illness and the psychiatric comorbidity.

摘要

背景

会诊联络精神病学(C-LP)是身心健康之间的一个交叉领域,精神科医生成为医疗团队的一部分,以便采用整体方法治疗患者。

目的

我们的研究旨在了解精神科住院转诊患者中C-LP服务的模式和效用。

设置与设计

这项观察性描述性研究记录了一家三级护理医院精神科两个月内的住院转诊情况。

对象与方法

采用迷你国际神经精神病学访谈(M.I.N.I.)来确定共病的精神科诊断。

结果

大多数收到的住院转诊患者为30至60岁的男性(73.7%)(58%)。总体而言,急诊科和重症监护病房(ICU)的转诊率显著更高(50%),其次是专科(内科和外科)病房(20%)和超级专科(心脏病学、胃肠病学和肿瘤学)病房(16%)。意识改变和躁动是最常见的转诊原因(42%),其次是酒精/药物戒断(21.6%)、躯体不适(7.3%)、情绪低落、睡眠障碍和故意自伤(各6%)。物质使用障碍,包括酒精和阿片类药物(32%)、谵妄(25%)和抑郁症(19%),是转诊患者中最常见的精神科诊断。

结论

观察到的模式表明,与病房相比,大多数因意识改变而进行心理评估的住院转诊患者来自急诊科和ICU。C-LP的效用有助于理解躯体疾病与精神科共病之间的相互依存关系。

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