Referral to a Liaison Psychiatrist from a palliative care unit

Ramsay, Noreen

doi:10.1177/026921639200600109

Cited by 8 publications

(14 citation statements)

References 12 publications

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“…The results support the view that ‘anxiety and depression are under‐detected and under‐treated in palliative care patients’ (NCHSPCS 2000, p. 12), because referrals for these problems increased as awareness developed within the team. The referral rate of 45% of patients for depression is almost exactly the same as that reported by Ramsay (1992) and the prevalence of 50% estimated by McDaniel et al (1995). Furthermore, the substantial increase in the number of patients seen in their final admission confirms the development in the psychologist's role, as patients’ emotional distress became a more important reason for referral.…”

Section: Discussionsupporting

confidence: 85%

“…Of the subgroup of the hospice patients seen by the psychologist, only 10% had a psychiatric history. This is far less than the rates of 39% reported by Stedeford & Bloch (1979), 25% by Ramsay (1992) and 31% by Mitchell (1998) and may be because our catchment area is semi‐rural rather than urban. Furthermore, in less than a third of these patients was it necessary to seek psychiatric advice while they were in the hospice, suggesting that a psychiatric history is not necessarily a major risk factor for emotional problems in palliative care.…”

Section: Discussionmentioning

confidence: 55%

“…A broader aim has been to provide feedback to the hospice multidisciplinary team on referral practice and encourage reflection on its clinical functioning. The audit would also permit a comparison with the results of Stedeford & Bloch (1979), Ramsay (1992) and Mitchell (1998), all of whom were liaison psychiatrists in a hospice.…”

Section: Methodsmentioning

confidence: 99%

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An investigation of inpatient referrals to a clinical psychologist in a hospice

Alexander¹

2004

Eur J Cancer Care

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A clinical psychologist, in a new post in a hospice, developed an assessment, therapeutic and consultation role. A retrospective, diary-based audit was made of the inpatients referred during the first 2 years, allowing an examination of referral practices and changes over time as the psychologist's role developed. During the 2 years 11% of the hospice inpatients were referred, consistent with previous published work in this area. Referrals increased from 10% in year 1 to 12% in year 2. Referrals were not skewed in terms of patient gender or diagnosis but younger patients were referred more. Comparison with other studies suggests the psychologist's gender may influence referral rates of woman patients. Referrals for depression and anxiety increased in year 2 but decreased for pain. The number of patients seen with marital/family stresses also increased with time. Such patients required the most psychological input. Patients with problems of alcohol misuse or dementia were particularly challenging for the hospice team and specific training was developed. The psychologist's role is discussed in the light of these findings, particularly in enhancing the multidisciplinary team's holistic approach to the patient and their family, by emphasizing the patient's experience and the collaborative basis of care.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 55%

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An investigation of inpatient referrals to a clinical psychologist in a hospice

Alexander¹

2004

Eur J Cancer Care

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“…The findings of a prevalence of depression as defined by the PSE at 22% in this study is lower than that of (Galusko 1996), with 37% of patients undergoing palliative care at home having a psychiatric disorder. When terminally ill patients were referred to a psychiatrist (Hinton 1972; Ramsay 1992), depression was the commonest diagnosis accounting for 42% to 54% of cases, but these were a selected sample of patients referred for psychiatric opinion. The timing of the assessment of depression has previously been reported to be a factor in the prevalence (Silverstone 1990) and may explain why previous studies have produced such differing estimates for the prevalence of depression as they were conducted at different times during the patient’s illness.…”

Section: Discussionmentioning

confidence: 99%

Depression in palliative care patients - a prospective study

Lloyd‐Williams

Friedman

2001

European Journal of Cancer Care

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Psychological and psychiatric morbidity can be a major source of distress to terminally ill patients and their relatives and friends. A prospective study was carried out to determine the prevalence of undiagnosed depression in palliative care patients and to determine whether factors such as age, previous psychiatric history and perceived social support have any association with the development of depression when patients have advanced metastatic cancer. Patients aged between 18 and 70 years who had a prognosis of < or = 6 months and who were receiving palliative care only for advanced metastatic cancer were interviewed using the Present State examination interview and a semi-structured interview to determine social support, information needs and past psychiatric history. One hundred patients were recruited and the prevalence of depression according to International Classification of Diseases 10 criteria was 22%. Perceived informal social support and past psychiatric history were not associated with being a case of depression but perceived information needs had a weak association. Younger patients and patients with breast cancer were more likely to be identified as being cases of depression. Further research is necessary to explore the aetiology and outcome of depression in palliative care. A high index of suspicion for depression should be maintained for younger patients with advanced metastatic cancer.

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“…[1][2][3] Psychiatrists have a recognized role in helping to manage co-morbid conditions including depression and complicated delirium in IPCU patients. 4 However, IPCU admission for primarily psychiatric indications has not been previously described.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric Indications for Admission to an Inpatient Palliative Care Unit

Peteet

Meyer

Thomas

et al. 2009

Journal of Palliative Medicine

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As inpatient palliative care units (IPCUs) have become more widespread, experience grows regarding the patients for whom they are best suited. We report here on the use of an IPCU in the treatment of several individuals with comorbid psychiatric and advanced life-threatening illness during a 1-year period. At least four categories of such patients-those with suicide risk, dangerous noncompliance, anxiety with substance dependence and diagnostic dilemmas-may benefit uniquely from the individualized, whole person, interdisciplinary approach of an IPCU. Effective referral and comanagement of these patients requires both close collaboration between psychiatric and palliative care clinicians, and awareness of the advantages and limitations of alternatives such as inpatient medical and psychiatric units.

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Referral to a Liaison Psychiatrist from a palliative care unit

Cited by 8 publications

References 12 publications

An investigation of inpatient referrals to a clinical psychologist in a hospice

An investigation of inpatient referrals to a clinical psychologist in a hospice

Depression in palliative care patients - a prospective study

Psychiatric Indications for Admission to an Inpatient Palliative Care Unit

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