THE PRACTICE OF CONSULTATION-LAISON PSYCHIATRY AND ASSOCIATED MEDICAL DIAGNOSIS ACROSS TWO (2) CENTERS IN SOUTH-SOUTH NIGERIA.
Keywords:
Consultation-Liaison psychiatry, referral, diagnostic profile, clinical, diagnostic errors.Abstract
Background: Consultation-liaison psychiatry (C-LP) which acts as an interface between physical and psychological health, underscores the fact that some medical disorders occurring in psychiatric settings can co-exist and cause diagnostic delays and missed diagnoses which may lead to poor prognosis and outcomes. Aims: Our study aimed to explore the pattern and utility of CLP services among inpatient referrals to the Mental Health/Psychiatry Units to determine the associated medical diagnosis and their co-morbid psychiatric diagnostic profiles across 2 centers in South-South, Nigeria Materials and Methods The study was done in centers across two states in a cross-sectional descriptive study that examined diagnostic profiles of 134 in-patient psychiatric referrals of patients who received medical care over one year (July 2021-July 2022) using questionnaires generated by the clinical team, across different medical and surgical specialties. Data analysis: was done using SPSS version 27. Results: The results showed that most of the received inpatient referrals had a preponderance of females with a frequency of 66.4% compared to 33.6% for males. The most predominant age range was 10-19 years with 57 (42.5%) patients and 78.6% participants below 30 years. Most patients (49.25%) were married, and 41.79% were single. Seizure-like episodes were the most common reason for referral from other medical and surgical specialties (19.4%). Overall, the referral rate was significantly higher from the Family Medicine department (40%) while the specialty with the least frequent referrals was Gynaecology (0.7%). Neurological conditions were the most prevalent diagnosis in the psychiatric settings used for the assessment, with a value of 67.1%. Gynecological conditions were the least frequent diagnosis with a value of 0.7%. Conversion Disorder (18.7%), Organic psychosis (14.9%), and schizoaffective disorder (10.4%) were the most prevalent associated CLP diagnoses while attention deficit hyperactivity disorder (ADHD0 was the least co-morbid psychiatric disorder with a value of (1.5%). Conclusions: Clinicians, including the psychiatrist, in the multidisciplinary team must be aware of the risk of medical diagnosis encountered in neuropsychiatric settings and vice versa to reduce diagnostic errors, mitigate morbidity, and ultimately improve the outcome of organic conditions
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