JNMA J Nepal Med Assoc. 2013 Jan-Mar;52(189):238-44.

Psychiatric morbidity patterns in referred inpatients of other specialties.

Risal A1, Sharma PP.
Author information
Abstract
INTRODUCTION:
Consultation-liaison psychiatry is an upcoming field dealing with interdepartmental
collaboration heading into multidisciplinary and holistic care. In general hospital
setting, psychiatrists need to be involved in evaluation of patients referred from
other specialties. This study analyzed the psychiatric morbidity among the
inpatients referred to Psychiatry Department from different wards in a Tertiary care
University Teaching Hospital.
METHODS:
Total 385 subjects were referred to the Department of Psychiatry from different
wards during a period of one year. Each of them underwent a detailed psychiatric
evaluation by a consultant psychiatrist once they were medically stable. Psychiatric
diagnosis was considered as per International Classification of Disease-10 criteria.
RESULTS:
The mean age of the subjects evaluated was 37.26 (1.86); most of them were
females 216 (56.4%), married 287 (74.5%), and homemaker 159 (41.3%). Maximum
271 (70.4%) referral was from Medical ward, and most of them 292 (75.8%) were
admitted in general bed. The most common medical diagnosis was self-poisoning
115 (30.6%) followed by alcoholic liver disease 49 (12.7%); while the commonest
123 (31.9%) psychiatric diagnosis was depression (including Dysthymia and
Adjustment disorder). Depression remained the commonest diagnosis among those
referred from medical ward 131 (34.7%); while anxiety was mostly found in the
emergency referral 94 (24.5%). Significant Correlation (P <0.05) was seen between
the source of referral and Psychiatric diagnosis.
CONCLUSIONS:
Psychiatric consultation was sought mostly by medical ward that had maximum
number of patients presenting with self-poisoning. The commonest diagnosis seen
in the referred in-patients was depression and anxiety disorder.

Javed Akhtar, Saeed Farooq, Ashfaq Ali.

Psychiatric referrals in a multidisciplinary hospital
J Postgrad Med Inst Oct - Dec 2004;18(4):626-30.
Department of Psychiatry, DHQ Hospital, Bannu & Postgraduate Medical Institute,
Lay Reading Hospital, Peshawar
Objective: To evaluate the pattern of psychiatric referrals and to study the various
diagnostic categories associated with physical disorders. Material and Methods: The
study was conducted at Khyber Teaching Hospital Peshawar over a period about
three months. There were 100 psychiatric referrals during the study period. Patients
were assessed on a structured proforma and psychiatric morbidity was classified
according to ICD-10. Results: Out of 100 patients, females (62%) outnumbered the
males. The most common reasons for the referral were unexplained physical
symptoms (40%) and disruptive behavior (15%). Depression was the most common
diagnosis made (40%). More than two third of the patients (72%) were referred from
medical units. 8% had no psychiatric morbidity. Conclusion: There is a need for
greater dialogue and interactions between referring doctor and consultant
psychiatrists

Mazhar Malik, Nadeem Abbas, Nadia Azad.

Psychiatric co-morbidity in medical and surgical in-patients, referred for
Psychiatric Consultation
J Rawal Med Coll Jun 2008;12(1):19-24.
Fauji Foundation Hospital, Rawalpindi.
To assess by Liaison Psychiatry the pattern of psychiatric co-morbidity in ref rred
medical and surgical in-patients in a tertiary care hospital. Methods: This was a
descriptive study, conducted at Department of Psychiatry, out-patien services in
Fauji Foundation Hospital, Rawalpindi. One hundred consecutive hospitalized paients
referred to Department of Psychiatry from Medical and Surgical Units of Fauji
Foundation Hospital were enrolled in the study during a period of seven months. A
semi structured proforma was used for collection of demographic data and detailed
information regarding reasons of psychiatric referral along with current medical and
surgical complaints. Results: Mean age of the sample was 39.9 years, 77% of the
patients were female and majority of the patients, 62% were married. All the
patients belonged to either poor class (61%) or lower middle class (39%).
Professional categories showed house wives (54%) comprising the major group and
25% were students. Majority of the patients, 56% were referred from medical
departments and the main reason for referral was medically unexplained physical
symptoms (36%) of one hundred consultations. General Health Questionnaire 12
(GHQ-12) screened 89% of cases with psychiatric co-morbidity as compared to 11%
non cases without psychiatric symptomatology. Majority (51%) of the patients had
diagnosis of depressive episode, mild moderate or severe and 19% of the patients
had dissociative (conversion) disorder as the second commonest diagnosis.
Conclusions: There is generally a low referral rate despite significant psychiatric
morbidity among medical and surgical in-patients. Further studies should be
conducted in the field of liaison psychiatry to address other variables such as length

of hospital stay, use of laboratory investigations and pattern of prescription

medicines.

Majid A Abidi, Amin A Gadit.

Liaison Psychiatry and referral rates among hospitalized patients
J Coll Physicians Surg Pak May - May 2003;13(5):274-6.
Department of Psychiatry, Hamdard university Hospital, Karachi
Objective: The study was conducted to assess the psychiatric co-morbidity among
general hospital patients and their rate of referrals. Design: A hospital based
descriptive observational study. place and duration of study: The study was
conducted in a private teaching hospital for a period of 6 months. Method: All
admitted patients in different disciplines were assessed on a structured proforma
supplemented by detailed psychiatric interview on positive cases. Morbidity
patterns were assessed on the basis of ICD-10 classification. The total referral
record was also maintained and compared with the data of morbidity and the
number of referred cases. Results: Out of the total 487 patients seen, 180 patients
were found to have psychiatric co-morbidity; depression outnumbered all
psychiatric disorders followed by mixed anxiety depression and somatoform
disorders. Married female formed the majority group and the vulnerable age was
between 41 to 60 years. Large segment of patients belonged to the discipline of
internal medicine with the lowest (12%) referral rate. Out of 121 patients, referred
from department of psychiatry, 44% were seen by the department of medicine
followed by the gynecology and other disciplines. Conclusion: There is generally a
low referral rate despite significant mental health co-morbidity. Training is needed
for non-psychiatrists and there is a need for development of consultation-liaison
psychiatry services in hospitals.