Liaison Psychiatry During the Peak of the Coronavirus Pandemic: A Description of Referrals and Interventions

Abstract

Introduction: The novel coronavirus SARS-CoV-2 belongs to the coronavirus family, a group of viruses that can cause upper respiratory infections in humans. Among other symptoms, it can present as an asymptomatic infection or as a more severe disease requiring hospitalization. Neuropsychiatric symptoms have been described in the acute phase of the illness and as long-term repercussions. We describe the characteristics and interventions in those COVID-19 patients referred to our liaison psychiatry service.Materials and Methods: This is a cross-sectional descriptive study. This study was carried out within the Department of Psychiatry of Cruces University Hospital (Basque Country, Spain). Data from each psychiatric consultation within our consultation-liaison service were consecutively obtained for 1 month from March 17 to April 17, 2020. We recruited data regarding clinical and referral characteristics and psychiatric interventions.Results: Of a total of 721 SARS-CoV-2 hospitalizations, 43 (5.6%) patients were referred to our psychiatry liaison service. The median age was 61 years old, and 62.8% were women. The infectious disease department was the most frequent petitioner (37.2%), and the most common reason for referral was patient anxiety (25.6%). A total of 67.4% of patients received psychological counseling and 55.8% received some pharmacological approach, with a median of 3.7 visits/calls per patient. In addition, 20.3% needed a medication switch due to potential interactions between psychotropics and drugs used to treat SARS-CoV-2.Discussion: In our study, up to 5.6% of SARS-CoV-2 hospitalized patients needed a psychiatric evaluation, especially for anxiety and mood symptoms. Psychosocial factors associated with the pandemic, drugs used to treat the infection, or a direct causative effect of the virus may explain our findings.

COVID-19-Related Psychosocial Care in General Hospitals: Results of an Online Survey of Psychosomatic, Psychiatric, and Psychological Consultation and Liaison Services in Germany, Austria, and Switzerland

“…Regarding the general population, in a multicentric study (n = 20,712 participants) from Italy, one of the western countries most severely hit by COVID-19, access to mental health services during the pandemic was reported in 7.7% of cases (23); among those referred to mental health services, in 93.9% of the cases (n = 1,503 subjects), a psychological assessment was requested and in 15.7% of the cases (n = 252) a psychiatric consultation. In hospitalized COVID-19 patients, COVID-19 comes with a high incidence of psychological distress and neuropsychiatric symptoms; up to 85% of critically ill COVID-19 patients have neuropsychiatric manifestations; also uninfected patients are affected by the pandemic with psychosocial distress and worsening preexisting mental disorders (2,24,25). Confronted with this situation, 34% of CL services providing COVID-psyCare reported additional offers for patients.…”

Liaison psychiatry before and after the COVID-19 pandemic

“…Mental Health research after the onset of the pandemic has mainly focused on the psychiatric manifestations of COVID-19 ( Roy et al, 2021 ; Steardo et al, 2020 ) and on the consequences that the social factors derived from the pandemic have on the Mental Health of the population ( Gloster et al, 2020 ; Hossain et al, 2020 ). The activity of LPTs is an opportunity to improve the understanding of the relationship between the coronavirus and psychiatric care, as this is still a hot area for research, and much more information is needed ( Cabrera et al., 2020 ; López-Atanes et al., 2021 ; Shapiro et al., 2021 ).…”