CONSULTATION-LIAISON

PSYCHIATRY
Consultation-Liaison Psychiatry
It is the study, practice and
teaching of the relation
between medical and
psychiatric disorders.
C-L Psychiatrists
serve as consultants to medical
colleagues (either another psychiatrist or,
more commonly, a nonpsychiatric
physician) or
to other mental health professionals
(psychologist, social worker, or psychiatric
nurse)
consult regarding patients in medical or
surgical settings and provide follow-up
psychiatric treatment as needed


Roles of a C-L Psychiatrist
skillful and brief interviewer
good psychiatrist and psychotherapist
teacher
knowledgeable physician who
understands the medical aspects of the
case
C-L Psychiatry
Associated with all the diagnostic,
therapeutic, research and teaching
services that psychiatrists perform in the
general hospital and serves as a bridge
between psychiatry and other specialties.
SCOPE
1. Understand the impact of medical illness and
the system in which it is treated and how this
affects the presentation, experience, and impact
of psychiatric and psychosocial morbidity.

2. Conduct a biopsychosociocultural
assessment, create a formulation and implement
appropriate treatment in the context of the
general hospital including effective
communication with the rest of the treatment
team.
3. Assess reactions to illness, and
differentiate the presentation of depression
and anxiety in the medical setting.

4. Understand the trajectories of illness
and the developmental issues of the
person with mental health problems and
mental illness.
5. Ability to assess and treat somatization
and somatoform disorders.

6. Ability to assess and manage common
neuropsychiatric disorders, with a
particular emphasis on delirium.
7.Understand the particular needs of
special populations with psychiatric and
psychosocial morbidity in the medical
settings, including the young, the old, the
indigenous, and those with intellectual
disabilities.

8. Assess and manage acute and
emergency presentations of psychiatric
morbidity in the general medical setting.
C-L Psychiatrists
Treat psychiatric problems in medical
patients.

Commonly treated problems: anxiety,
sleep disorders, disorientation, often as a
result of delirium.
Recommend specific medications

Identify and organize the patient's social cupport
systems

Address the immediate problem through short-
term, dynamic psychotherapy

Develop a plan to deal with the petient's social
or occupational problems

COMMON CONSULTATION-
LIAISON PROBLEMS
1. SUICIDE ATTEMPT OR THREAT
2. DEPRESSION
3. AGITATION
4. HALLUCINATIONS
5. SLEEP DISORDER
6. CONFUSION
7. NONCOMPLIANCE OR REFUSAL TO
CONSENT TO PROCEDURE
8. NO ORGANIC BASIS FOR SYMPTOMS


PROBLEMS IN HOSPITALIZED
MEDICAL PATIENTS
Resistance to treatment for medical
complications of substance abuse

Chronic psychiatric illness in a patient admitted
for other reasons

Medical complications of psycotropic agents

Medical complications of a suicide attempt
PATIENTS AT RISK
Patients with AIDS

Patients undergoing renal dialysis

Patients undergoing surgery

Patients treated in the ICU

Transplantation issues

Psychooncology
THANK YOU :-)