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Consultation-Liaison Psychiatry

Sandeep Grover, Sudhir Mahajan, Subho Chakrabarti, Ajit Avasthi
AIM: To evaluate the effectiveness of quetiapine and haloperidol in patients of delirium referred to psychiatry consultation liaison services. METHODS: The study followed a single blind randomised controlled trial design. Thirty-two patients in the haloperidol group and 31 patients in the quetiapine group were assessed at the baseline and 6 consecutive days. Flexible dosing regimen (haloperidol: 0.25-1.25 mg; quetiapine 12.5-75 mg/d) was used. Delirium Rating Scale-Revised-98 (DRS-R-98) and mini mental status examination (MMSE) were the primary and secondary efficacy measures respectively...
September 22, 2016: World Journal of Psychiatry
Paul Cammell
OBJECTIVES: This article reviews recent trends in the provision of psychiatric services to the emergency departments of tertiary hospitals in Australia, involving the establishment of specialised in-reach or liaison services as well as various forms of short stay unit attached to emergency departments. The Emergency Psychiatry Service at Flinders Medical Centre, South Australia, is described as a case example. Its specialised models of assessment and clinical care are described, highlighting how these are differentiated from more traditional models in inpatient, community and general hospital consultation-liaison psychiatry...
September 6, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Hiran Thabrew
OBJECTIVES: The objectives of this study were to examine the experiences of dual-trained child psychiatrists and paediatricians in Australia and New Zealand and inform the review of the Dual Fellowship Training Programme by the Royal Australian and New Zealand College of Psychiatrists and Royal Australasian College of Physicians. METHODS: All dual-trained child psychiatrists and paediatricians and current trainees were electronically surveyed in 2015. RESULTS: Seven out of eight specialists (88%) and four out of six trainees (67%) responded...
September 2, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
G E Maccaferri, A O Rossetti, J Dalmau, A Berney
BACKGROUND: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a relatively newly identified autoimmune neuropsychiatric disorder that predominantly affects children and young adults. Although psychiatric symptoms are highly prevalent and frequently severe, it has mainly been reported in neurological, but not psychiatric, literature. Understanding this form of encephalitis, its quick diagnosis and which treatment to provide are of utmost importance for consultation-liaison (C-L) psychiatrists...
May 2016: Brain Disorders & Therapy
James Armontrout, David Gitlin, Thomas Gutheil
BACKGROUND: Previous research in the area of medical decision-making capacity has demonstrated relatively poor agreement between experienced evaluators in "gray area" cases. We performed a survey to determine the level of agreement about gray area decision-making capacity case scenarios within and between individuals of different professional backgrounds. METHOD: Participants received a survey consisting of 3 complicated decision-making capacity vignettes with an accompanying "yes/no" question regarding capacity and a certainty scale for each vignette...
September 2016: Psychosomatics
K Niranjan Prasad, P B Sajeev Kumar, O K Narayanankutty, Amal Abraham, Zoheb Raj, Vinayak Madanagopal, Akash Balu
PURPOSE: This study is to assess the attitude of the medical interns toward psychiatry, psychiatrists and patients with mental health problems. MATERIALS AND METHODS: A personal data sheet and the Balon et al. questionnaire was used to assess the attitude among medical interns (n = 44) of a medical college in Northern Kerala. RESULTS: There was modestly good attitude toward psychiatry throughout the study. Data were compared between interns who have completed their posting in psychiatry and those who have not...
April 2016: Indian Journal of Psychiatry
Thomas R Blair
Psychiatrists, psychologists, and other mental health professionals were among the first and most crucial responders to HIV/AIDS. Given an epidemic in which behavior and identity played fundamental roles, mental health professionals were uniquely positioned to conduct social research to explain the existence and spread of disease; to develop clinical understanding of psychological aspects of HIV/AIDS as they emerged; and to collaborate with affected communities to promote education and behavioral change. This study examines the roles of mental health professionals as "plague doctors" in San Francisco's response to HIV/AIDS, in the early years of the epidemic...
2016: Bulletin of the History of Medicine
Philip Blumenshine, Alison E Lenet, Lauren K Havel, Melissa R Arbuckle, Deborah L Cabaniss
OBJECTIVE: Although psychiatry residents are expected to achieve competency in conducting psychotherapy during their training, it is unclear how psychotherapy teaching is integrated across diverse clinical settings. METHODS: Between January and March 2015, 177 psychiatry residency training directors were sent a survey asking about psychotherapy training practices in their programs, as well as perceived barriers to psychotherapy teaching. RESULTS: Eighty-two training directors (44%) completed the survey...
June 9, 2016: Academic Psychiatry
Pornjira Pariwatcharakul, Supachoke Singhakant
Clinicians routinely assess patients' mental capacity on a daily basis, but a more thorough assessment may be needed in complex cases. We aimed to identify the characteristics of inpatients in a general hospital, who were referred to a liaison psychiatry service for mental capacity assessment, reasons for the referrals, and the factors associated with their mental capacity. A 6-year retrospective study (2008-2013) was conducted using data collected routinely (e.g., age, gender, diagnosis, Thai Mental State Examination score, reasons for the referral, and the outcome of capacity assessment) on referrals for mental capacity assessment to a Consultation-liaison Psychiatry Unit at a university hospital in Thailand...
May 7, 2016: Psychiatric Quarterly
Anne P F Wand, Rebecca Wood, Matthew D Macfarlane, Glenn E Hunt
OBJECTIVE: Consultation-liaison psychiatry (CLP) services vary in terms of structure, function and responsiveness. It is not known whether evaluation measurements can be meaningfully compared across different CLP services to assess value and efficiency. The aim was to develop and test a common tool for measuring process and outcome measures in CLP. METHODS: A data collection tool was developed using the literature and consultation with CLP clinicians. The tool was used to prospectively gather referral data, response times, health utilisation data and functional outcomes for individuals referred over seven months to three different CLP teams, servicing inner city, district and regional areas...
May 2016: Journal of Psychosomatic Research
Francesca Arpone, Florian Combremont, Kerstin Weber, Paolo Scolozzi
Burning mouth syndrome (BMS) is a medical condition that is often refractory to conventional diagnostic and therapeutic methods. Patients suffering from BMS can benefit from a biopsychosocial approach in a joint, medical-psychological consultation model. Such a consultation exists at Geneva University Hospitals, involving the collaboration of the maxillo-facial and oral surgery division and the division of liaison psychiatry and crisis intervention, in order to take into account the multiple factors involved in BMS onset and persistence...
February 10, 2016: Revue Médicale Suisse
Philip R Muskin, Anne Skomorowsky, Ravi N Shah
OBJECTIVE: We report on a quality improvement program to co-manage patients with co-morbid medical and psychiatric disorders in the general hospital. A philanthropic donation allowed a high volume, high-acuity urban hospital to hire a co-managing inpatient psychiatrist. The expectation was that facilitating psychiatric evaluation/treatment of medical patients would result in fewer patients staying beyond the expected length of stay (LOS). METHOD: The psychiatrist became a member of a general medical team working with a group of internists and actively co-managing medical patients...
May 2016: Psychosomatics
Sanjeev Sockalingam, Ahmad Alzahrani, Christopher Meaney, Rima Styra, Adrienne Tan, Raed Hawa, Susan E Abbey
OBJECTIVES: The aim of this study was to determine the relationship between the time to referral (TTR) to psychiatric consultation and the length of stay (LOS) after adjusting for medical comorbity. METHODS: Using a naturalistic study design, we collected and analyzed inpatient consultation-liaison psychiatry service data over a 12-month period from 2 Canadian hospital sites. Data collected included demographic characteristics, referral characteristics, Charlson Comorbidity Index to measure medical comorbidity severity, psychiatric diagnoses, type of psychiatric intervention, and time variables, namely TTR and LOS...
May 2016: Psychosomatics
Maeve Leonard, Shane McInerney, John McFarland, Candice Condon, Fahad Awan, Margaret O'Connor, Paul Reynolds, Anna Maria Meaney, Dimitrios Adamis, Colum Dunne, Walter Cullen, Paula T Trzepacz, David J Meagher
OBJECTIVES: Differentiation of delirium and dementia is a key diagnostic challenge but there has been limited study of features that distinguish these conditions. We examined neuropsychiatric and neuropsychological symptoms in elderly medical inpatients to identify features that distinguish major neurocognitive disorders. SETTING: University teaching hospital in Ireland. PARTICIPANTS AND MEASURES: 176 consecutive elderly medical inpatients (mean age 80...
2016: BMJ Open
Atsuko Koyama, Hirokuni Okumi, Hiromichi Matsuoka, Chihiro Makimura, Ryo Sakamoto, Kiyohiro Sakai
BACKGROUND: As the number of immigrants to Japan increases, the health problems of foreign nationals also have an increasing impact on Japanese medical institutions. The aim of this study was to clarify the Japan-specific health problems related to both the physical and psychological symptoms of foreign nationals from the viewpoint of psychosomatic medicine. The second aim was to clarify the measures that should be taken in Japan and similar countries where immigration may still be considered less than common...
2016: BioPsychoSocial Medicine
Sandeep Grover, Siddharth Sarkar, Ajit Avasthi, Savita Malhotra, Ashish Bhalla, Subhash K Varma
AIM: To compare "consultation" and "hybrid" models of consultation-liaison (CL) services provided to patients visiting the medical emergency outpatient services. MATERIALS AND METHODS: Over the period of 18 months, two different models of consultation psychiatry services (July 2012 to March 2013-consultation model, April 2013 to December 2013 hybrid model) were compared. In the consultation model, the psychiatry resident was available on call to the internists. Whereas, for the hybrid model psychiatry resident was stationed in the medical emergency and was available to assess the patients directly requiring psychiatric evaluation...
October 2015: Indian Journal of Psychiatry
David C Sheridan, John Sheridan, Kyle P Johnson, Amber Laurie, Allyson Knapper, Rongwei Fu, Shannon Appy, Matthew L Hansen
BACKGROUND: Pediatric emergency department (PED) visits among children and adolescents with acute mental health needs have increased over the past decade with long wait times in the PED awaiting disposition. OBJECTIVE: The objective of this study was to evaluate the effect of a new pediatric mental health liaison program with the hypothesis that this model reduces length of stay (LOS) and hospitalization rates among pediatric mental health patients. METHODS: This was a pre- and postintervention retrospective study of the year prior to (June 2012-June 2013) and the year after (October 2013-October 2014) implementation of a new PED psychiatric team...
March 2016: Journal of Emergency Medicine
Yasuyuki Okumura, Kotaro Hatta, Ken Wada, Takashi Takeuchi, Yasuhiro Kishi
BACKGROUND: There is little expert consensus as to which drugs should comprise the first-line pharmacological treatment for delirium. We sought to assess experts' opinions on the first-line oral and injection drugs for delirium associated with a diverse range of clinical features using a rating-based conjoint analysis. METHODS: We conducted a cross-sectional study. We mailed a questionnaire to all consultation-liaison psychiatrists/educators certified by the Japanese Society of General Hospital Psychiatry...
June 2016: International Psychogeriatrics
Jeffrey DeVido, Anna Glezer, Linda Branagan, Alvin Lau, James A Bourgeois
BACKGROUND: Many hospitals do not have regular access to psychiatry consult services. This is well understood as a common shortage at nonacademic community hospitals (especially in rural environments, and may also be a problem at noncontiguously located smaller hospitals that are affiliated with academic medical centers in urban settings. The authors sought to deliver timely inpatient psychiatric consultation-liaison services via telemedicine to a local but physically separated hospital affiliated with an academic medical center...
July 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
André Do, Saeid Noohi, Dominique Elie, Artin A Mahdanian, Ching Yu, Marilyn Segal, Karl J Looper, Soham Rej
BACKGROUND: Reports have suggested that citalopram and escitalopram may prolong the QTc interval, leading Health Canada to issue a warning to limit their dosages in 2012. Little is known about the effects of this warning and similar ones (e.g., by the Food and Drug Administration) on antidepressant prescribing in inpatients with acute medical illness, who are theoretically at high risk of QTc prolongation. The main objective of our study is to examine the effect of the Health Canada warning on citalopram/escitalopram prescribing patterns in the consultation-liaison (C-L) psychiatry setting...
January 2016: Psychosomatics
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