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Consult liaison

Michael Matthew McClay, Stephen S O'Connor, Brittany Nicole Groh, Marissa Baudino, Lisa Venanzi, Angela Shields, Jo Ellen Wilson, John Bone, Stephen Nicolson
OBJECTIVE: Evidence suggests that suicide attempts by self-inflicted gunshot wound (GSW) are underreported and may in turn affect disposition following hospitalization. This study aimed to evaluate the clinical characteristics and use of services among individuals who do not disclose suicidal intent following a self-inflicted GSW. METHODS: Electronic medical record data from 128 survivors of self-inflicted GSWs at a level 1 trauma center were analyzed to identify factors associated with nondisclosure of a suicide attempt to medical staff...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Courtney D Nordeck, Christopher Welsh, Robert P Schwartz, Shannon Gwin Mitchell, Art Cohen, Kevin E O'Grady, Jan Gryczynski
BACKGROUND: Substance use disorders (SUD) are associated with non-adherence to medical care and high utilization of hospital services. This study characterized patterns and correlates of rehospitalization among patients seen by a hospital-based SUD consultation-liaison (CL) team. METHODS: This study was a retrospective medical record review of patients in a large urban academic hospital who received SUD consultation and were diagnosed with opioid, cocaine, and/or alcohol use disorder (N = 267)...
March 2, 2018: Drug and Alcohol Dependence
F Lynch, C Kehoe, S MacMahon, E McCarra, R McKenna, A D'Alton, E Barrett, A Twohig, F McNicholas
Introduction Paediatric Consultation Liaison Psychiatry Services (PCLPS) are specialised services treating mental health difficulties co-morbid with medical problems. Methods Standardised clinical data was retrieved from all case notes (N=108) during the study timeframe (Jan-June 2016). Results The majority of children were female 59 (55%) with a mean age of 13. Presentation was typically via the Emergency Department (ED) (85, 79%), and of those, the majority (53, 62%) were 'out of hours' and for Deliberate Self-harm (44, 52%) Almost half of all cases seen (50, 46%) were previously known, and discharged back (84, 78%), to CAMHS...
December 18, 2017: Irish Medical Journal
Anne Pf Wand, Swapnil Sharma, Lindsay J Carpenter, Mike Gatsi
OBJECTIVES: Consultation-liaison psychiatry (CLP) services sit between mental health and the general hospital, and risk being poorly understood by both systems. The aim of this study was to develop an operational manual for a CLP service, which defined functions and governance. METHODS: The CLP literature was reviewed with a focus on descriptions of CLP roles, organisational processes, quality measures and service development. The CLP team held service planning meetings and met with members of the mental health and hospital executives...
February 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Vaios Peritogiannis, Soultana L Papadopoulou, Athina Tatsioni, Artemis Kapsalaki, Vassiliki Siafaka, Katerina Kotsi, Avraam Ploumis
Background: Physical injury has been associated with the development of several psychopathological manifestations. Less is known about the use of psychiatric medication in those patients. Objectives: This study aimed to explore the use of psychiatric medication by patients been admitted in a rehabilitation center in a tertiary care teaching hospital and to inquire for the correlations of such drug administration. Materials and Methods: The sample consisted of 127 patients who had been admitted to a rehabilitation center, being in the postacute phase of their condition during a 2-year period...
January 2018: Journal of Neurosciences in Rural Practice
Ariela Green, Daniel Neff, Greg Giuliano, Nathan Lee, Rachel Turchin, Elisabeth J S Kunkel
BACKGROUND: Diagnosis and treatment of alcohol use disorders and their sequelae are common clinical questions for the consultation-liaison psychiatrist. At an urban, academic medical center, the authors consulted on several patients whose consumption of alcohol included nonbeverage forms of alcohol, (described in the literature as surrogate alcohols, nonbeverage alcohols, e.g., mouthwash). METHODS: The authors describe 4 patients who presented with surrogate alcohol consumption...
January 4, 2018: Psychosomatics
Celine Lewis, Melissa Hill, Owen J Arthurs, John C Hutchinson, Lyn S Chitty, Neil Sebire
OBJECTIVE: To assess health professionals' and coroners' attitudes towards non-minimally and minimally invasive autopsy in the perinatal and paediatric setting. METHODS: A qualitative study using semistructured interviews. Data were analysed thematically. RESULTS: Twenty-five health professionals (including perinatal/paediatric pathologists and anatomical pathology technologists, obstetricians, fetal medicine consultants and bereavement midwives, intensive care consultants and family liaison nurses, a consultant neonatologist and a paediatric radiologist) and four coroners participated...
February 8, 2018: Archives of Disease in Childhood
Chrysanta Patio, Nabilah Ali, Jill Ketner, Candy Young, Esther Chou, Carrie Chong, Wanchi Su
This chapter explores the role of advanced practice clinicians (APCs) and patient care coordinators in the head and neck cancer setting. APCs, which include physician assistants (PAs) and nurse practitioners (NPs), are licensed professional healthcare providers who diagnose and treat illnesses, order and interpret diagnostic tests, and prescribe pharmaceutical and non-pharmaceutical therapies. Although the training, education, and licensure differ between PAs and NPs, their roles are quite similar in head and neck surgery...
2018: Cancer Treatment and Research
Sandeep Grover, Siddharth Sarkar, Lakshmi Narayana Yaddanapudi, Abhishek Ghosh, Amit Desouza, Debasish Basu
Background and Aims: The study aimed to assess the rates of delirium in an Intensive Care Unit (ICU) prospectively assessed with a delirium screening instrument and confirmed through psychiatrist evaluation. In addition, the referral rate to psychiatric consultation liaison services from the same ICU was assessed through the rates of psychiatric referral over the previous 10 years. Material and Methods: In the prospective part of the study, consecutive patients aged 16 years or more admitted to the ICU of a tertiary care hospital were assessed daily for delirium using confusion assessment method for the ICU, a validated instrument that can be used for both mechanically ventilated and nonventilated patient by trained heath care personnel...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Susanne Saal, Uta Kirchner-Heklau, Tobias Müller, Kai Wohlfarth, Farsin Hamzei, Melanie Müller, Susanne Strobel, Carsten Clewing
OBJECTIVE: To identify factors influencing the current transition practice and to generate aspects to improve transition. METHODS: Expert interviews and group discussions with health care professionals; a scoping review and a standardized interview with stroke patients 6 weeks after discharge via telephone. RESULTS: 14 expert interviews and 3 group discussions (n=18) were conducted. Factors influencing transition at home were communication of professionals between and within settings, social support and role behavior of stroke patients...
January 29, 2018: Die Rehabilitation
Tarek M Shahrour, Sona Mohan, Muez Siddiq, Khadija El Hammasi, Taoufik Alsaadi
The objective of this study was to examine the relationship between legal status and guardedness in patients who attempted suicide in Abu Dhabi, United Arab Emirates. The consultation-liaison team assessed 355 patients admitted for suicidal/self- injurious behavior, recording their guardedness before knowing whether they were legally charged. Patients who were legally charged for the suicidal act (n = 139) were 1.6 times (p = .03) more guarded in volunteering information than patients who were not legally charged...
January 24, 2018: Death Studies
M Brinkers, G Pfau, C Schneemilch
BACKGROUND: Owing to a rise of psychosomatic comorbidities, the treatment of psychological disorders, which may negatively impact prognosis and therapy, is increasingly becoming a focus of attention for pain outpatient clinics. AIM: This study investigates and discusses the advantages of liaison psychiatric care in a university pain clinic. METHODS: In this retrospective study, we investigated all patients who presented to an anaesthesiologically led pain clinic between January and June 2014...
January 19, 2018: Der Schmerz
Anton Schmick, Josef Jenewein, Sönke Böttger
Substance use disorders are becoming an increasingly significant problem in general hospitals and hence play a key role in consultation- and liaison psychiatry. Diverse psychotropic effects of various substances mimic psychiatric disorders. An alcohol intoxication can present depressive or manic symptoms, a cannabis delirium can present as a psychosis while stimulants use can suggest the diagnosis of an anxiety disorder. Obtaining dual diagnoses by identifying substance-induced and non-substance-induced psychopathologies is clinically challenging...
January 11, 2018: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
Yan Chen, Enyan Yu, Zhengluan Liao, Yunfei Tan, Yaju Qiu, Junpeng Zhu, Sisi Lin, Minghao Wu
Objective This study aimed to identify misdiagnosed or undiagnosed psychiatric disorders and the factors associated with these disorders in patients with sleep problems who are referred to a consultation-liaison service. Method Records of all inpatients receiving a consultation from the Psychiatry Department between January and December 2016 were retrospectively reviewed. Psychiatric diagnoses were analyzed using descriptive statistics, and the factors associated with the risk of these disorders in patients with sleep problems were determined by multiple logistic regression analysis...
January 1, 2018: International Journal of Psychiatry in Medicine
Petya Bogdanova-Mihaylova, David Burke, John P O'Dwyer, David Bradley, Jennifer A Williams, Simon J Cronin, Shane Smyth, Raymond P Murphy, Sinead M Murphy, Catherine Wall, Dominick J H McCabe
BACKGROUND: Patients with 'suspected viral encephalitis' are frequently empirically treated with intravenous aciclovir. Increasing urea and creatinine are 'common', but rapidly progressive renal failure is reported to be 'very rare'. AIMS: To describe the clinical course and outcome of cases of aciclovir-induced acute kidney injury (AKI) encountered by the Liaison Neurology Service at AMNCH and to highlight the importance of surveillance and urgent treatment of this iatrogenic complication...
January 6, 2018: Irish Journal of Medical Science
Catherine Orsak, Abey Thomas, Paul Bush, E Sherwood Brown
Background With the increase use of pay for performance in healthcare, 30-day readmissions after discharges are critically important. Objective A team-based psychiatric consultation approach was tested in an inpatient hospital setting. This is the first study that examines 30-day readmission rate with this approach. Methods In this quality improvement study, 164 patients received a team-based psychiatric consultation that included daily meetings during the weekdays between psychiatrists and hospitalists and 436 received care of treatment-as-usual or traditional consultation-liaison services...
January 1, 2017: International Journal of Psychiatry in Medicine
Aleksandra Bacewicz, Katherine Martin
Consult-liaison psychiatrists often encounter difficult clinical scenarios. We present a pediatric case of presumptive coprophagia. After a negative medical work-up, the pediatrics team asked psychiatry to assist them in managing this relatively rare disorder in the hospital setting. Little is known about the etiology and treatment of coprophagia in the pediatric population. Using the case as a catalyst, we discuss what is known about this disorder as well as treatment strategies in the hospital setting.
2017: Case Reports in Psychiatry
Andrea Young, Devidas Menon, Jackie Street, Walla Al-Hertani, Tania Stafinski
BACKGROUND: Patients and their families have become more active in healthcare systems and research. The value of patient involvement is particularly relevant in the area of rare diseases, where patients face delayed diagnoses and limited access to effective therapies due to the high level of uncertainty in market approval and reimbursement decisions. It has been suggested that patient involvement may help to reduce some of these uncertainties. This review explored existing and proposed roles for patients, families, and patient organizations at each stage of the lifecycle of therapies for rare diseases (i...
December 22, 2017: Orphanet Journal of Rare Diseases
Pinar Tosun Tasar, Sevnaz Sahın, Nur Ozge Akcam, Cıgdem Dınckal, Merve Gulsah Ulusoy, Ozan Fatih Sarıkaya, Soner Duman, Fehmi Akcıcek, Aysin Noyan
OBJECTIVE: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients. METHODS: The medical records of 1435 patients over 65 years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates...
November 27, 2017: International Journal of Psychiatry in Clinical Practice
G Mattei, A Laghi, S Balduzzi, M Moscara, C Piemonte, C Reggianini, M Rigatelli, S Ferrari, L Pingani, G M Galeazzi
OBJECTIVE: The objective of this study was to identify possible biopsychosocial predictors of organizational complexity in patients referred to the consultant psychiatrist for assessment before liver transplantation. METHODS: This was a case-control study. All psychiatric consultations performed before and after liver transplantation from January 1, 2008 to December 31, 2013 were included. Complexity was operationalized as "undergoing two or more psychiatric consultations"...
November 2017: Transplantation Proceedings
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