Consultation-Liaison Psychiatry—from theory to clinical practice: an observational study in a general hospital

Abstract

BackgroundTo investigate significant association between various clinical and extra-clinical factors brought out the activities of Consultation-Liaison Service.MethodsData from all psychiatric consultations for patients admitted to the Perugia General Hospital and carried out over a 1-year period (from July the 1st 2009 to June the 30th 2010) were collected by a structured clinical report including: socio-demographic features, features of referrals, features of back-referrals. T-test, Mann–Whitney U-test, χ2-test and Fischer’s were statistically used.Results1098 consultations were performed. The consultations carried out the Emergency Unit were excluded from the study. The type and the reasons for the referrals were discussed such as the ICD-10 diagnosis and the liaison interventions too. Significant associations emerged between gender and: social status and occupation (p < 0.05 and p < 0.01 respectively). Clinical sector related with reason for referral (p < 0.01), type of consultation (p < 0.01), liaison investigations (p < 0.01) and long-term treatment plan after hospital discharge (p < 0.01). The ICD-10 psychiatric diagnosis (Schizophrenia, Affective Syndrome and Neurotic-StressSomatoform Syndrome) was associated with social status (p < 0.01), social condition (p < 0.01), consultation type (p < 0.01), advice (p < 0.01) and reason for consultation (p < 0.01).ConclusionsThe need for better physical and psychological investigation is confirmed in order to promote not only disease remission but overall wellbeing.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1375-6) contains supplementary material, which is available to authorized users.

Introduction and geographic disparity of consultation-liaison psychiatry in Japan: Retrospective analysis of data from the Japanese National Inpatient database.

“…After the introduction of CLP services in 2012, the provision of CLP was consistently increased (Table 1), implying the recognition of the need for CLP services in medical and surgical patients. Also, almost 70% of patients we studied who received CLP services were over the age of 65 in 2016, which was much higher than in recent studies in a Canadian setting (roughly 42% from two academic tertiary care hospitals) (21) and an Italian setting (mean and SD age was 57.9 ±19.4 from one general hospital) which were in line with other reports from Europe in terms of demographic data (about 41%) (22). We speculated that this is due to the difference in the aging ratio of the study population, criteria for referral, priority/availability for CLP referral, and the healthcare system.…”

Consultation-Liaison Psychiatry for Outpatients in a Great Metropolitan Hospital

“…It is worth noting that psychiatric disorders, even when sub-clinical, worsen outcome whereas their early detection and treatment reduce health care costs significantly (De Giorgio et al, 2015;Ormel et al, 1999). Lipowsky (1983) defined consultation-liaison psychiatry (CLP) as "a sub-specialisation of psychiatry focusing on diagnosis, treatment, study and prevention of psychiatric morbidity in patients with organic pathologies and those with somatisation" (p. 329).…”

Psychiatric Referral Pattern in a General Hospital

“…10,11 Patients with psychiatric disorders give much priority to the somatic symptoms due to which they tend to visit general physician rather than psychiatrists for the treatment of their physical symptoms. 12,13,14,15 Another reason may be due to lack of awareness about the psychiatric origin of the physical symptoms and due to social stigma about the psychiatric illnesses.…”

“…This finding was in agreement with the majority of other previous studies. [5][6][9][10][11]15 The reasons for their referral were mainly for multiple somatic complains which could not be explained through any medical diagnoses. Alcohol and substance related disorders were quite common.…”