Common but unexplored psychiatric morbidity among referred indoor patients: A Liaison study in India
Introduction
The Consultation-Liaison (C-L) psychiatry has been reported and studied in Europe, South East Asia and several other parts of the world.1, 2, 3, 4 Studies in this field are aimed to assess and manages the acute or emergency presentation of psychiatric morbidity including depression and suicidal incidence in the general medical settings.5, 6, 7 A growing body of evidences indicates that there is an association between physical illness and psychiatric disorder.5, 8, 9 Several reports reveal that Consultation-Liaison psychiatry has also been practiced in several parts of the world especially in the western world.10, 11, 12 The demographic and clinical characteristics of referrals to Liaison psychiatry have been studied in different countries and diagnostic services have been provided accordingly.13 In a consultation practice in general hospital settings; the psychiatrist offers recommendations to patients who are referred to him by other physicians, surgeons, and gynecologists. Reports reveal that the prevalence of mental-illness in chronically physically-ill patient is more than 40 percent, particularly with the criterion of lifetime substance abuse, depression and mood/anxiety related disorders.14 The importance of the present study has been shown in several investigations in India and other countries.8, 9, 15 In spite of a higher prevalence of C-L Psychiatric morbidities in India, the overall referral rate is only 1.48%.16
In this background, the present study is undertaken to assess the incidence of mental disorder of psychiatric referrals from general medicine, chest medicine and cardiology departments. In addition, correlations have been drawn between rural and urban incidence taking into account the other possible socio-demographic determinants. Our study is absolutely important to address the high occurrence of psychiatric symptoms from non-psychiatric domain. Furthermore, a brief discussion and critical analysis have been made on several psycho-social risk factors which can influence the psychological makeup of individuals, large group of the masses and as a whole total community.
Section snippets
Study population and sampling
The present study was conducted at Medical College, 88 College Street, Kolkata-73, which is one of the most ancient medical teaching institution in South East Asia. One hundred and two consecutive cases referred as new cases during 12 months period (1.1.2008–31.12.2008) from general medicine (GM), chest medicine (CHM) and cardiology departments (CAM) was considered as the study population. The inclusion criteria were (1) ‘new cases’ referred for the first time from medicine allied indoors for
Number of admission in and referral from different departments
A total number of admissions of patients in different departments are presented in Table 1. A large number of referrals are attributed mainly from the general medicine and chest medicine departments.
Age vs sex wise distributions of patients
Table 2 shows the distributions of total number of patients (N = 102) into two sex groups that are found to be similar. The age-wise distribution, however, shows that more than two-third (67.65%) belongs to age range (16–45) years. The percentage of the patients in the age group of less than 16 years
Discussion
Considering the percentage wise referrals in psychiatry from the total number of admissions in three departments it is found that the general medicine (0.90%) and chest medicine (0.93%) have the higher contribution. This trend is comparable with various studies such as Parekh and Deshmukh,30 Malhotra9 and Wig and Shah.31 The present findings on the sex dependant distribution of patients indicate that two variables viz., age and sex are independent and either sex of adolescent and only male of
Conflict of interests
None.
Acknowledgements
All authors sincerely wish a long and quality life of the participants in the present investigation.
References (51)
- et al.
Training in consultation-liaison psychiatry in Eastern Europe
Journal of Psychosomatic Research
(2012) - et al.
Future developments in consultation-liaison psychiatry and psychosomatics
Journal of Psychosomatic Research
(2005) - et al.
Liaison psychiatry in an Indian general hospital
General Hospital Psychiatry
(1984) - et al.
Consultation-liaison psychiatry: a new psychiatric subspecialty in Switzerland
Journal of Psychosomatic Research
(2011) - et al.
Evaluative research in consultation-liaison psychiatry. Review of the literature: 1970–1981
General Hospital Psychiatry
(1982) Test–retest reliable coefficients and 5-year change scores for the MMSE and 3MS
Archives of Clinical Neuropsychology
(2005)Isle of Wight revisited: twenty-five years of child psychiatric epidemiology
Journal of the American Academy of Child & Adolescent Psychiatry
(1989)- et al.
Increased rate of conduct problems in urban areas: what is the mechanism?
Journal of the American Academy of Child and Adolescent Psychiatry
(1996) Epidemiology of women and depression
Journal of Affective Disorders
(2003)Liaison mental health nursing: origins, definition and prospects
Journal of Advanced Nursing
(1997)
Sociodemographic profile, clinical factors, and mode of attempt in suicide attempters in consultation liaison psychiatry in a tertiary care center
Industrial Psychiatry Journal
Consultation-liaison psychiatry: a psychosomatic service in the general hospital
International Journal of Psychiatry in Medicine
Somatoform disorders: the role of consultation liaison Psychiatry
International Review of Psychiatry
Psychiatric morbidity in non-psychiatric geriatric inpatients
Indian Journal of Psychiatry
Study on liaison psychiatry in general hospitals
Indian Journal of Psychiatry
Research in consultation-liaison psychiatry: the Toronto General Hospital experience
Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Referrals to a liaison psychiatry outpatient clinic
Scottish Medical Journal
Kaplan & Sadock's synopsis of psychiatry, behavioral science/clinical psychiatry
Liaison psychiatry & Indian research
Indian Journal of Psychiatry
Liaison psychiatry in an Indian general hospital
The DSM-IV Text Revision: rationale and potential impact on clinical practice
Psychiatric Services
Comparison of the Glasgow Coma Scale and the Reaction Level Scale for assessment of cerebral responsiveness in the critically ill
Intensive Care Medicine
Glasgow Coma Scale: variation in mortality among permutations of specific total scores
Intensive Care Medicine
Assessing consciousness in critically ill patients. Yearbook of intensive care and emergency medicine
Statistical validation of the Glasgow Coma Score
Journal of Trauma
Cited by (0)
- 1
Both authors have equal contribution in this investigation.