TRENDS IN THE CLINICAL PRACTICE OF LIAISON PSYCHIATRY AT A TERTIARY CARE HOSPITAL IN LAHORE, PAKISTAN
Abstract
Objectives: To ascertain the trends in referrals made to the Department of Psychiatry from all other departments of Mayo Hospital, Lahore, Pakistan.
Study design: Descriptive cross-sectional research design.
Place and duration of study: Mayo hospital, Lahore, Pakistan. Six months (Dec,2023-June,2024)
Methodology: Convenience sampling was used to select participants, consisting of patients admitted to all wards at Mayo Hospital requiring Psychiatric consultation. Patients were enrolled using a pre-designed online form. Data included details of participants' age and gender, number and type of consultation, reason for hospital admission, reason for referral, active complaints, past psychiatric history, mental status examination, co-morbidities, risk of self-harm or harm to others and management plan. Informed verbal consent was obtained from each patient. Patients who refused to give informed consent were excluded. Data analysis was performed using SPSS 27.
Results: 220 patients received Liaison Psychiatric services, the most patients (36.4%) were admitted in General Medicine followed by (19.5%) in General Surgery. Majority (26.8%) were adolescents and 89.1% consulted a Psychiatric service for the first time. 53.2% women received liaison Psychiatric services. History of substance use was reported by 20%. The commonest reason for admission was multiple comorbidities (16.4%). Majority of the patients were referred to Psychiatric services with symptoms of depression (21.8%), self-injurious or suicidal behavior (14.5%), altered state of consciousness (14.1%), substance use disorders (14.1%), irritability or uncooperative behavior (11.8%), acutely disturbed behavior (10.9%).
Conclusion: Consultation model is being used by physicians however, there is a need to educate the clinical teams about Liaison Psychiatry model to help solve difficult liaison cases.
Downloads
References
2. Scott J, Aitken P, Peters T, Kumar K. Liaison psychiatry explained. BMJ. 2017 May 8;357.
3. Dua D, Grover S. Profile of patients seen in consultation-liaison psychiatry in India: A systematic review. Indian journal of psychological medicine. 2020 Nov;42(6):503-12.
4. Abidi MA, Gadit AA. Liaison psychiatry and referral rates among hospitalized patients. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP. 2003 May 1;13(5):274-6.
5. Minhas A, Bender KG, Minhas FA. Development of a psychiatric liaison service in Rawalpindi, Pakistan. BJPsych International. 2015 May;12(S1):S-1.
6. Malik MF, Najeeb B. Retrospective Chart Review of Patients with Self-Harm Seen as Liaison Psychiatry in Pakistan. European Psychiatry. 2022 Jun;65(S1):S251-.
7. Saeed H, Siddiqui SA, Mansoor M, Khan MM. Liaison psychiatry in low & middle income countries: Experiences at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. Asian Journal of Psychiatry. 2020 Feb 1;48:101889.
8. Abuse S. Mental Health Services Administration (SAMHSA).(1999). Screening and assessing adolescents for substance use disorders. 1991.
9. Alvi MH, Ashraf T, Naz F, Sardar A, Ullah A, Patel A, Kiran T, Gumber A, Husain N. Burden of mental disorders by gender in Pakistan: analysis of Global Burden of Disease Study data for 1990–2019. BJPsych Bulletin. 2023 Sep 29:1-8.
10. Hansen AH, Høye A. Gender differences in the use of psychiatric outpatient specialist services in Tromsø, Norway are dependent on age: a population-based cross-sectional survey. BMC health services research. 2015 Jun;15:1-0.
11. Niaz U. Women's mental health in Pakistan. World psychiatry. 2004 Feb;3(1):60.
12. Insan N, Weke A, Rankin J, Forrest S. Perceptions and attitudes around perinatal mental health in Bangladesh, India and Pakistan: a systematic review of qualitative data. BMC Pregnancy and Childbirth. 2022 Apr 6;22(1):293.
13. Lutz NM, Neufeld SA, Hook RW, Jones PB, Bullmore ET, Goodyer IM, Ford TJ, Chamberlain SR, Wilkinson PO. Why is non-suicidal self-injury more common in women? Mediation and moderation analyses of psychological distress, emotion dysregulation, and impulsivity. Archives of suicide research. 2023 Jul 3;27(3):905-21.
14. Grover S, Sarkar S, Avasthi A, Malhotra S, Bhalla A, Varma SK. Consultation-liaison psychiatry services: Difference in the patient profile while following different service models in the medical emergency. Indian Journal of Psychiatry. 2015 Oct 1;57(4):361-6.
15. Husain W. Barriers in seeking psychological help: public perception in Pakistan. Community Mental Health Journal. 2020 Jan;56(1):75-8.
16. Grover S, Naskar C. Models of consultation-liaison psychiatry: A scoping review. Journal of Mental Health and Human Behaviour. 2023 Jul 1;28(2):116-25.
Copyright (c) 2024 Journal of Pakistan Psychiatric Society
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright © JPPS. Published by Pakistan Psychiatric Society
Licensing: This work is licensed under Creative Commons Attribution-NonCommercial 4.0 International License
Readers may “Share-copy and redistribute the material in any medium or format” and “Adapt-remix, transform, and build upon the material”. The readers must give appropriate credit to the source of the material and indicate if changes were made to the material. Readers may not use the material for commercial purposes. The readers may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
.png)
