Profile of Patients Seen in Consultation-Liaison Psychiatry in India: A Systematic Review

Abstract

Objectives: This review aimed to evaluate all the published studies from India conducted in the consultation-liaison (CL) psychiatry setting to identify the diagnostic patterns and referral rates in this setting. Understanding the same can help in organizing the services and knowing the training needs. Materials and Methods: A thorough literature search was done in August 2020 using different search engines (PubMed, Medknow, and Google Scholar). This was followed by an individual search of various Indian Psychiatry journals and a hand search of references in the available articles. Only those studies that described patients referred to psychiatry services from various specialties were included. Results: A total of 33 studies were selected for the review. More than half of them were published in the last 5 years. Studies have primarily reported psychiatric profile medically ill inpatients referred to CL psychiatry services, with the majority of the studies reporting the number of patients seen for the duration of at least 1 year. The referral rates for inpatients across different institutes have varied from 0.01% to 3.6%. The referral rates from emergency set-ups have varied from 1.42% to 5.4%, and in outpatients, from 0.06% to 7.17%. The most commonly diagnosed psychiatric disorders across different studies include depression; organic disorders, including delirium; substance use; intentional self-harm; and anxiety disorders. Conclusions: A limited number of studies have reported the profile of patients seen in CL psychiatry setups. Available data from these studies suggest that referral rates to psychiatry services from other specialists are dismal. There is an urgent need to change the focus of psychiatry training at both undergraduate and the postgraduate levels to enhance the psychiatric knowledge of physicians to improve psychiatry referrals.

Liaison psychiatry before and after the COVID-19 pandemic

“…On the other hand, the percentage of patients treated for substance use disorder decreased dramatically, which would be related to confinement and changes in the consumption pattern during the studied months ( Benschop et al, 2021 ; Villanueva et al, 2021 ). However, the diagnoses made by the LPTs during the months prior to the pandemic were similar to those collected in the literature, which also remained stable in recent decades ( Dua & Grover, 2020 ; Huyse et al, 2001; Sánchez- González et al, 2018 ).…”

Pattern of psychiatric referral in a tertiary care hospital

“…8 As per studies, the referral rates for inpatient varies from 0.01 % to 3.6%, for emergency setup varies from 1.4% to 5.4% and for outpatients the referral rate varies from 0.06% to 7.17% . 9 Though psychiatric services are available in almost all teaching hospitals in Nepal, very little is known about the pattern of referral from other department. Literature on the pattern of psychiatric referral is scarce in our setting.…”

Delirium Research in India: A Systematic Review

“…62 Other studies from India, which have focused on the prevalence of various psychiatric disorders among patients seen in CLP setting, suggest that the prevalence of delirium ranges from 0.2 to 0.53% in all the admitted patients. 178 These findings suggest that delirium should form a major focus for CLP training. Further, it can be said that focusing on delirium in undergraduate training can lead to a reduction in stigma associated with psychiatry, in medical professionals.…”