PATTERN OF PSYCHIATRIC REFERRALS IN A TERTIARY CARE PUBLIC SECTOR HOSPITAL OF KARACHI

Main Article Content

Anum Haider
Saima Qureshi
Kheenpal das
Muhammad Ilyas Jat
Muhammad Tariq Arain

Abstract

Objective: To observe the frequency and pattern of Psychiatric referrals by Emergency and In-patient Departments (IPD) of tertiary care public sector hospital of Karachi.


Methodology: A comparative cross-sectional study was conducted in the referred cases of Emergency (ER) and In-patient Department (IPD) for Psychiatric consultation from December 2019 to May 2020. The available medical records and International Classification of Diseases (ICD-10) diagnostic criteria were used for assessment and the record register was maintained on regular basis for data collection. The Data was analyzed to compare the findings in both ER and IPD.


Results: There was a total of 281 referrals recorded in the register during six months. Among those112 (39.9%) were made from ER while 169 (60.1%) were from IPD. Most of them were young (33.4±13.5 years) and were almost equally distributed in both genders [Male=141 (50.2%) and Female=140 (49.8%)]. Altered or disorganized behavior, 88 (31.3%) followed by unexplained somatic complaints, 36 (12.8%,) and past psychiatric history, 25 (8.9%) were the most frequent reason for a referral from IPD. Suicide and deliberate self-harm were more common in ER (12, 4.3%) than that in IPD (6, 2.1%).


Conclusion: Overall the frequency of Psychiatric referrals was low in comparison to the patient population and most of those were from the inpatient department than the ER.

Article Details

How to Cite
1.
Haider A, Saima Qureshi, Kheenpal das, Muhammad Ilyas Jat, Muhammad Tariq Arain. PATTERN OF PSYCHIATRIC REFERRALS IN A TERTIARY CARE PUBLIC SECTOR HOSPITAL OF KARACHI. J Postgrad Med Inst [Internet]. 2022 Mar. 31 [cited 2024 Apr. 19];36(1):13-9. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/2982
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Original Article

References

- Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. The Lancet Psychiatry. 2016 Feb 1;3(2):171-8.

- Alonso J, Petukhova MV, Vilagut G, Bromet EJ, Hintov H, Karam EG, Alonso J, Chatterji S, He Y. Days totally out of role associated with common mental and physical disorders. The burdens of mental disorders: Global perspectives from the WHO World Mental Health surveys. 2013 May 9:137-48.

- Tekkalaki B, Tripathi A, Arya A, Nischal A. A descriptive study of pattern of psychiatric referrals and effect of psychiatric intervention in consultation-liaison set up in a tertiary care center. Indian Journal of Social Psychiatry. 2017 Apr 1;33(2):165.

- Mathur P, Sengupta N, Das S, Bhagabati D. A study on pattern of consultation liaison psychiatric service utilization in a tertiary care hospital. J Res Psychiatry Behav Sci. 2015;1:11-6.

- Tekkalaki B, Patil VY, Chate SS, Patil NM, Patil S, Sushruth V. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study. Journal of Mental Health and Human Behaviour. 2017 Jan 1;22(1):40.

- 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;57(4):361.

- Minhas A, Bender KG, Minhas FA. Development of a psychiatric liaison service in Rawalpindi, Pakistan. BJPsych International. 2015 May;12(S1):S-1.

- Imam SZ, Hashmi SH, Islam MG, Hussain MA, Iqbal F, Ilyas M, Hussain I, Naqvi SH, Khan MM. Students' Corner Liaison psychiatry and depression in medical inpatients. JPMA. The Journal of the Pakistan Medical Association. 2007;57(3):159.

- Thompson AE, Anisimowicz Y, Miedema B, Hogg W, Wodchis WP, Aubrey-Bassler K. The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC family practice. 2016 Dec;17(1):1-7.

- Liddon L, Kingerlee R, Barry JA. Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking. Br J Clin Psychol. 2018 Mar;57(1):42-58. doi: 10.1111/bjc.12147.

- Singh G, Chaudhury S, Saldanha D, Singh V, Marella S, Vhora R. Psychiatric emergency referrals in a tertiary care hospital. Medical Journal of Dr. DY Patil Vidyapeeth. 2018 Jul 1;11(4):312.

- Ghani Khan A, Shahbaz NN. 10-year pattern of admissions in psychiatric unit at a tertiary care hospital in pakistan. Pakistan Journal of Neurological Sciences (PJNS). 2016;11(2):59-64.

- Jurewicz I. Mental health in young adults and adolescents–supporting general physicians to provide holistic care. Clinical Medicine. 2015 Apr;15(2):151.

- Gustavson K, Knudsen AK, Nesvåg R, Knudsen GP, Vollset SE, Reichborn-Kjennerud T. Prevalence and stability of mental disorders among young adults: findings from a longitudinal study. BMC psychiatry. 2018 Dec;18(1):1-5.

- Ranjan S, Poudel R, Pandey P. Pattern of psychiatric referral from emergency department of a tertiary level hospital in Nepal. Journal of Universal College of Medical Sciences. 2015;3(2):5-9.

- Singh SM, Subodh BN, Mehra A, Mehdi A. Reactions to psychiatry referral in patients presenting with physical complaints to medical and surgical outpatient services. Indian Journal of Psychological Medicine. 2017 Sep;39(5):605-10.

- Bhogale GS, Nayak RB, Dsouza M, Chate SS, Banahatti MB. A cross-sectional descriptive study of prevalence and nature of psychiatric referrals from intensive care units in a multispecialty hospital. Indian Journal of Psychological Medicine. 2011 Jul;33(2):167-71.

- Reeves RR, Pendarvis EJ, Kimble R. Unrecognized medical emergencies admitted to psychiatric units. The American journal of emergency medicine. 2000 Jul 1;18(4):390-3.

- Heslop L, Elsom S, Parker N. Improving continuity of care across psychiatric and emergency services: combining patient data within a participatory action research framework. Journal of advanced nursing. 2000 Jan;31(1):135-43. doi: 10.1046/j.1365-2648.2000.01251.x. PMID: 10632802.

- 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..

- Mudgal V, Rastogi P, Niranjan V, Razdan R. Pattern, clinical and demographic profile of inpatient psychiatry referrals in a tertiary care teaching hospital: a descriptive study. General psychiatry. 2020;33(4).

- Chakravarty S, Nandi S, Bhandari SS, Das S. A study on the patterns of psychiatric referrals in a tertiary care hospital in the north-eastern part of India. Journal of evolution of medical and dental sciences. 2020 Aug;9(31):2217.

- Grover S, Kate N, Mattoo SK, Chakrabarti S, Malhotra S, Avasthi A, Kulhara P, Basu D. Delirium: Predictors of delay in referral to consultation liaison psychiatry services. Indian journal of psychiatry. 2014 Apr;56(2):171.

- Chen KY, Evans R, Larkins S. Why are hospital doctors not referring to consultation-liaison psychiatry?–a systemic review. BMC psychiatry. 2016 Dec;16(1):1-2.

- Evans R, Connell J, Ablard S, Rimmer M, O'Keeffe C, Mason S. The impact of different liaison psychiatry models on the emergency department: a systematic review of the international evidence. Journal of Psychosomatic Research. 2019 Apr 1;119:53-64.

- Jackson J, Nugawela MD, De Vocht F, Moran P, Hollingworth W, Knipe D, Munien N, Gunnell D, Redaniel MT. Long-term impact of the expansion of a hospital liaison psychiatry service on patient care and costs following emergency department attendances for self-harm. BJPsych open. 2020 May;6(3).

- Ramanuj PP, Pincus HA. Collaborative care: enough of the why; what about the how?. The British Journal of Psychiatry. 2019 Oct;215(4):573-6.