Pattern of Referral of Patients with COVID-19 for Psychiatric Consultation: Experience at a Multidisciplinary Hospital in Karachi, Pakistan.

OBJECTIVE

To determine referral patterns for psychiatric consultations among COVID-19 patients encompassing both the in-patient and Emergency Department of a multidisciplinary hospital in Karachi, Pakistan.

STUDY DESIGN

A retrospective chart review. Place and Duration of the Study: The Aga Khan University Hospital, Karachi, Pakistan, from March 2020 to December 2021.

METHODOLOGY

The research team collected pertinent information from medical records using a standardised proforma, which encompassed data from physicians' notes, nurses' notes, assessment forms, and discharge summaries. The data were analysed using descriptive and inferential statistics.

RESULTS

This study examined 233 psychiatric referrals, with 67% male patients (n = 156) and 57.1% (n = 133) aged above 60 years. The primary psychiatric diagnosis was delirium (47.1%, n = 105), followed by adjustment disorders (10.8%, n = 27) and mood disorders (11.7%, n = 25). The main symptoms leading to consultation were agitation/confusion (45%, n = 106) and psychotropic adjustment (18%, n = 41). Clinical outcomes, including mortality, were associated with agitation/confusion (p = 0.001), delirium (p = 0.001), older age (p = 0.003), and longer length of stay (p = 0.001). Patients aged 61 years and above exhibited frequent agitation/confusion (p = 0.002) and delirium (p = 0.001). Longer stays correlated with agitation/confusion (p = 0.022), and a one-month hospital stay showed an association with delirium (p = 0.050).

CONCLUSION

This study highlights the crucial role of consultation-liaison psychiatric services in addressing the psychological issues in COVID-19 patients. The significance of delirium and its high mortality risk underscores the need for focused research and integration of mental health care into pandemic responses for comprehensive patient care.

KEY WORDS

Referrals, Psychiatric consultations, Hospitalised patients, COVID-19, Pakistan, Consultation-liaison services.