Evaluation of Psychiatric Morbidity in COVID-19-Positive Inpatients Referred to Consultation Liaison Psychiatry in a Tertiary Care Hospital

Abstract

Background: The COVID-19 pandemic has led to the risk of common mental illnesses. Consultation liaison psychiatry has been one of the most requested services in the face of this pandemic. We aimed to assess (a) the prevalence of psychiatric illness, (b) different types of psychiatric diagnoses, (c) presenting complaints, (d) reasons for psychiatric referrals, and (e) psychiatric intervention done on COVID-19 positive inpatients referred to consultation liaison psychiatry at tertiary care hospital. Method: This was a retrospective study of data collected from April 1, 2020, to September 15, 2020. Total 300 patients were referred and diagnosed with clinical interview and Diagnostic and Statistical Manual for Mental Disorder Fifth Edition criteria. Analysis was done using chi-square test, Kruskal–Wallis test, and fisher exact test. Results: Out of 300 patients, 26.7% had no psychiatric illness. Adjustment disorder was the commonest psychiatric diagnosis (43%), followed by delirium (10%). Statistically significant differences were found for parameters like Indian Council of Medical Research Category 4 of the patient, (hospitalized severe acute respiratory infection) (P value < 0.001), medical comorbidity (P value = 0.023), and past history of psychiatric consultation (Fisher exact test statistic value <0.001). Behavioral problem (27.6%) was the commonest reason for psychiatric referral. Worrying thoughts (23.3%) was the most frequent complaint. A total of 192 (64.3%) patients were offered pharmacotherapy. Conclusions: Psychiatric morbidity was quite high (73.3%) among them and adjustment disorder was the commonest (43%) psychiatric diagnosis followed by delirium (10%). Pharmacotherapy was prescribed to 64.3% patients and psychosocial management was offered to most of the referred patients.

Liaison psychiatry before and after the COVID-19 pandemic

“…The results of our study showed a significant reduction in hospitalizations for surgical reasons, non-surgical ICUs, and infections (non-COVID), increasing those related to COVID. This unforeseen consequence of the switch in care focus impacted the LPTs, as is described in other published studies ( Butler et al, 2021 ; Prajapati et al, 2021 ). In our study, the proportion of requests for suicide risk assessment decreased during the pandemic period, related to confinement.…”

“…On the other hand, there was an increase in the rate of a new diagnosis, the most frequent being adjustment disorders and delirium, both in a higher proportion than in previous months, especially in the case of delirium as reflected in the literature ( Rebora et al, 2021 ). There was also a significant decrease in bipolar disorder and neurocognitive disorder ( Butler et al., 2021 ; Prajapati et al., 2021 ).…”