Study of referrals to department of psychiatry in tertiary care general hospital setting

Abstract

Background: Study of referral pattern to psychiatry helps us to understand the type of patients and the rate of referral from individual departments. It also helps us to understand the need for consultation liaison services (CLP) thereby strengthening the General Hospital Psychiatric Units (GHPU) Aim: To study the referral pattern to psychiatry in a tertiary care teaching hospital. Materials and Methods: All referrals to the department of psychiatry for a period of two months were included in the study. Sociodemographic details, reasons for referral and the department from which referred were noted. The Psychiatric diagnosis was made according to the ICD-10 criteria. The overall referral rate to psychiatry and referral from individual departments was noted and descriptive statistics was applied to represent the same. Results: The overall referral rate to psychiatry was found to be 1.17% with majority being from medical specialities (62%). The most common reasons for referral have been suicidal attempts and most common psychiatric disorder diagnosed among referred has been delirium. Conclusion: The low levels of referrals to psychiatry emphasize the need for better consultation liaison services.

Diagnostic concordance in consultation liaison psychiatry – Referring physicians to psychiatrists

“…A study conducted in Telangana by Srilakshmi Pingali et al (2020) showed similar results, but most referrals were of age 25-35 years, unemployed, and belonging to low SES. 3 In a study conducted by Iniyan Selvamani et al (2022) in 310 referral patients, the mean age of the sample was 40.6 years with an SD of 16.3, and the majority (64.19%) were males. 8 In our study, the majority of the cases referred were inpatients (61%), and most of them were from the medical specialties (85%), [General medicine -55, Neurology-21] followed by surgical branches (15%).…”

“…"Liaison" refers to the linking up of groups for effective collaboration. 2 In a study conducted in Telangana by Srilakshmi Pingali et al (2020), most of the referrals were in the age group of 25-35 years, the majority were males (65%) and Hindu by religion (85%) and residing in rural areas (53.6%). Most of the patients were illiterate (37.9%), unemployed (30%), and belonged to low socioeconomic status (95%).…”

“…Most of the patients were illiterate (37.9%), unemployed (30%), and belonged to low socioeconomic status (95%). 3 Studies conducted by Kennedy J et al (2018), Macharapu R et al (2018), Reddy VV (2016), and Keertish N et al (2013) showed that the majority of cases were referred from the Department of General Medicine. [4][5][6][7] In A study done by Iniyan Selvamani et al (2022) in 310 referral patients, the mean age of the sample was 40.6 years with an SD of 16.3, majority were males (64.19%).…”

“…8 Earlier studies by Srilakshmi Pingali et al (2020) and Sandeep Grover et al (2017) showed the most common diagnosis by the psychiatry team is delirium (36.4%), followed by depression (12.1 %). 3,9 In India, a study on the concordance of diagnosis between the referral team and psychiatrist has shown low concordance (κ<0.3) for depressive disorders and delirium, while substance dependence (κ=0.678) and suicidality (κ=0.655) had better diagnostic concordance. 9 A study conducted by Keerthy Reji et al (2020) reported diagnostic concordance as 40.9%.…”