Characteristics of Child and Adolescent Psychiatry Consultations at a University Hospital and Accuracy Rates of Recognition of Childhood Psychiatric Diseases by Nonpsychiatry Specialists

Abstract

Objective: Physical and mental health are closely related. Psychiatric problems increase in the presence of a physical illness. Consultation liaison psychiatry provides a combination of medical treatment, psychiatric treatment, and psychosocial care to patients when necessary. In this study, we aimed to examine the consultation-liaison services provided by the child and adolescent psychiatry department of a university hospital within two years and to examine the accuracy rates of recognition of childhood psychiatric diseases nonpsychiatry specialists. Methods: Consultations for pediatric patients from other clinics were screened retrospectively at Gaziantep University Hospital between January 1st, 2018, and December 31st, 2019. Data relating to the departments requesting a consultation, reasons for consultation, diagnoses made by children and adolescent psychiatrists, and psychiatric treatments were evaluated. Results: A child and adolescent psychiatry consultations were requested for 290 children over a two-year period. The average age of the cases for whom consultation was requested was 12.1, and 61% of the cases were female. The most common reason for consultation was suicide attempts (26.6%). The most common mental disorder was depression (19%), while the most common intervention was psychoeducation (48.9%). The disorders with the highest diagnostic accuracy were delirium (100%), autism (100%), substance use disorders (80%), and mental disability (70%), while the disorders with the lowest diagnostic accuracy were psychotic disorder (0%), depression (%18,2) and anxiety disorder (22.2%). Conclusion:Mental disorders are common in children with physical illnesses, but the rate of correct recognition of childhood mental disorders by other physicians is low. The high rates of psychiatric disorders highlight the importance of educating physicians that work with children about childhood mental problems and cooperation between child psychiatrists and other physicians.

Comparison of Outpatient and Inpatient Consultations Requested from Child and Adolescent Psychiatry

“…Furthermore, the inpatient group had a much higher proportion of girls than the outpatient group. Previous research found that the majority of child and adolescent psychiatric consults were requested for inpatients [3,[14][15][16]. In contrast, most patients consulted in this study were outpatients, with more boys as inpatients and girls as outpatients.…”

“…In studies conducted in our country, the most common reason for requesting consultations from child and adolescent psychiatry were suicide attempts [3,5,15,16,18]. Suicide risk assessment was the most common reason for referral to child psychiatry in a recent review [2].…”

“…Previous studies revealed that the average age of cases ranged between 10 and 13, with a majority of girls [13][14][15]. However, only a few studies examining consultations requested fromchild and adolescent psychiatry have shown a predominance of boys [5].…”

“…However, there are variations in the most commonly reported diagnoses across studies. Most studies have reported that depressive disorders are the most frequent diagnosis [5,15]. Nevertheless, one study identified anxiety disorders as the most common diagnosis in consultation psychiatry [22].…”

Examination of Consultations Requested from the Child and Adolescent Psychiatry Clinic and Factors Predicting Subsequent Outpatient Clinic Attendance

“…26 A study conducted in our country in 2021 shows that the most common mental disorder diagnosis is depression (19%) as a result of consultation evaluation. 27 In a one-year retrospective study, in which a total of 302 patients were included and 94% of the patients were diagnosed with mental illness, the three most common diagnoses after the first consultation evaluation were conduct disorders (30.8%), anxiety disorders (22.5%) and depressive disorders (11.3%). 28 In a study by Şimşek et al, in which they evaluated the child psychiatry consultations requested for inpatients and outpatients, the most common psychiatric diagnoses were; major depressive disorder, conduct disorder, bipolar disorder.…”