Pattern of Psychiatry Referrals in a Tertiary Hospital Teaching Set-up

¹Senior Resident, Department of Psychiatry, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India

²Junior Resident, Department of Psychiatry, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India

*Corresponding Author: Sumeesha Jaswal, Senior Resident, Department of Psychiatry, Indira Gandhi Medical College and Hospital, Shimla, Himachal Pradesh, India; Email: [email protected]

Received Date: November 3, 2023

Publication Date: December 1, 2023

Citation: Jaswal S, et al. (2023). Pattern of Psychiatry Referrals in a Tertiary Hospital Teaching Set-up. Mathews J Psychiatry Ment Health. 8(4):45.

Copyright: Jaswal S, et al. © (2023)

ABSTRACT

Background: High rates of psychiatric morbidity to the tune of 20-65% are seen in medico-surgically ill patients but there is lack of research on concordance rates between Psychiatrist and Non- psychiatrist diagnoses of patients seen under Consultation liaison patients, especially in general hospital settings. Aim: To analyse pattern, reason of referrals, diagnostic and management concordance in patients with psychiatric morbidity in medico-surgical setting. Material and Methods: 2476 consecutive referrals received during a period of 6 months (1.11.2022-31.04.2023) in consultation liaison (CL) services in department of Psychiatry at a general hospital teaching institute were evaluated for reason of referral, psychiatric diagnosis and management given by the referring team vis-à-vis the CL team. Results: Emergency and inpatient referral rate was 0.77 % and 0.23%. Medicine and allied departments utilized CLP services majorly (51.3%), 1/4th referrals were for psychiatric emergencies (24.7%). 41.1% of referrals were requested even before primary treating team zeroed on the body organ system involved followed by multisystem involvement in 18.96% referrals. Most common diagnosis made by CLP team was substance use disorder (25.44%), anxiety disorder (20.39%), depression (12.27%), delirium (9.3%) and 4.4% being nil psychiatry. Diagnostic concordance for major psychiatric diagnoses between medicine/ surgery team and CLP team was fair in substance use disorder and anxiety disorders. Conclusion: The study findings suggest that substance use disorder is the most common diagnosis made by CLP team with a fair diagnostic concordance between medicine/surgery team and CLP team for substance use disorder and anxiety disorders. Oral/ parenteral psychotropic drugs were given in one third of cases even before CLP referral was initiated, resulting in higher frequency of side effects.