Clinical and cost benefits of liaison psychiatry

Levitan, Stephan J.; Kornfeld, Donald S.

doi:10.1176/ajp.138.6.790

Cited by 170 publications

(4 citation statements)

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“…11 Depression can also interfere with a patient's participation in rehabilitative and other measures, resulting in prolonged stay. 12,13 In our study, CD patients had a 2-day longer inpatient stay than UC patients, which may be due to an increased number of admissions for CD and an increased number of surgeries. 14 UC and CD were associated with an increased risk of depression in our analysis.…”

Section: Discussionmentioning

confidence: 62%

“…Conversely, patients without depression would not have as many confounding symptoms, resulting in a more accurate description of symptoms. 12 Subanalysis in the depressed cohort revealed that patients with CD had increased hospital charges of $17,974 compared to UC patients. Patients with CD had a higher medical cost, especially for the initial diagnosis, than patients with UC.…”

Section: Discussionmentioning

confidence: 99%

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Relation between inflammatory bowel disease, depression, and inpatient outcomes in the United States

Ali

Pamarthy

Bolick

et al. 2022

Baylor University Medical Center Proceedings

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The relationship between inflammatory bowel disease (IBD) and depression is complicated. The effect of depression on ulcerative colitis (UC) and Crohn's disease (CD) among the inpatient US population has not previously been studied. We retrospectively analyzed patients admitted with UC and CD from 2016 to 2019 using the National Inpatient Sample database. Our primary outcome was the effect of depression on hospital length of stay (LOS), costs, and mortality. Secondary outcomes included the comparison between UC and CD cases. In the UC population, 13.4% had depression, compared to 14.9% in the CD population. LOS was longer in UC and CD patients with depression (P < 0.001). Subgroup analysis revealed that LOS was longer in CD patients than UC patients in the depressed cohort (P < 0.001). Inpatient hospital costs were lower in IBD patients with depression (P < 0.001). Subgroup analysis revealed that hospital cost was $17,974 higher in CD patients than UC patients (P < 0.001). Depression did not increase mortality in the IBD population but increased LOS, with a greater impact on CD than UC. White women were found to have an increased prevalence of depression in the IBD population.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Relation between inflammatory bowel disease, depression, and inpatient outcomes in the United States

Ali

Pamarthy

Bolick

et al. 2022

Baylor University Medical Center Proceedings

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“…Psychotherapeutic models should comprehensively include collaboration between mental health specialists (psychologists, psychiatrists, social workers and neurologists). The task of future studies should be to carry out prospective, randomized and controlled psychosocial intervention studies investigating the efficacy of psychosomatic and psychosocial care in dermatology and, in particular, with certain skin disorders, as has already been done for other clinical specialties [30, 31, 32]. …”

Section: Discussionmentioning

confidence: 99%

Psychosomatic Liaison Service in Dermatology

et al. 2001

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Background: Empirical investigations examining the psychosocial distress and need for care of dermatology patients are rare. Little is known about the use of psychotherapeutic interventions in routine care. Objective: To evaluate the psychosocial distress of dermatological inpatients, the need for psychotherapeutic interventions and their realization in the framework of a psychosomatic liaison service. Methods: 86 patients from one unit at the University Dermatology Clinic in Freiburg underwent psychodiagnostic interviews and completed self-rating instruments, elucidating mental disorders, psychosocial distress, coping methods, quality of life, treatment motivation and psychotherapeutic interventions. Results: Using ICD-10 criteria, mental and behavioral disorders were diagnosed in 46%; most frequent were mood and anxiety disorders. Professional assessment indicated a need for psychotherapeutic treatment in 51%, while 28% of the patients wished for psychotherapy; actual intervention occurred in 38%. Conclusions: The need for psychotherapeutic treatment can only be handled within the framework of a liaison service in close collaboration with care givers.

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“…In fact, elderly patients with a fractured femur, with liaison psychiatrist input, were twice as likely to be discharged home and had a shorter length of stay, compared to patients with no psychiatric involvement [20]. Desan and his colleagues found that psychiatric consultation reduces length of stay for medical inpatients [21].…”

Section: Introductionmentioning

confidence: 99%

Why are hospital doctors not referring to Consultation-Liaison Psychiatry? – a systemic review

2016

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BackgroundConsultation-Liaison Psychiatry (CLP) is a subspecialty of psychiatry that provides care to inpatients under non-psychiatric care. Despite evidence of benefits of CLP for inpatients with psychiatric comorbidities, referral rates from hospital doctors remain low. This review aims to understand barriers to CLP inpatient referral as described in the literature.MethodsWe searched on Medline, PsychINFO, CINAHL and SCOPUS, using MESH and the following keywords: 1) Consultation-Liaison Psychiatry, Consultation Liaison Psychiatry, Consultation Psychiatry, Liaison Psychiatry, Hospital Psychiatry, Psychosomatic Medicine, the 2) Referral, Consultation, Consultancy and 3) Inpatient, Hospitalized patient, Hospitalized patient. We considered papers published between 1 Jan 1965 and 30 Sep 2015 and all articles written in English that contribute to understanding of barriers to CLP referral were included.ResultsThirty-five eligible articles were found and they were grouped thematically into three categories: (1) Systemic factors; (2) Referrer factors; (3) Patient factors. Systemic factors that improves referrals include a dedicated CLP service, active CLP consultant and collaborative screening of patients. Referrer factors that increases referrals include doctors of internal medicine specialty and comfortable with CLP. Patients more likely to be referred tend to be young, has psychiatric history, live in an urban setting or has functional psychosis.ConclusionThis is the first systematic review that examines factors that influence CLP inpatient referrals. Although there is research in this area, it is of limited quality. Education could be provided to hospital doctors to better recognise mental illness. Collaborative screening of vulnerable groups could prevent inpatients from missing out on psychiatric care. CLP clinicians should use the knowledge gained in this review to provide quality engagement with referrers.

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Clinical and cost benefits of liaison psychiatry

Cited by 170 publications

References 4 publications

Relation between inflammatory bowel disease, depression, and inpatient outcomes in the United States

Relation between inflammatory bowel disease, depression, and inpatient outcomes in the United States

Psychosomatic Liaison Service in Dermatology

Why are hospital doctors not referring to Consultation-Liaison Psychiatry? – a systemic review

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