Psychiatric Co-morbidity in Medical and Surgical In-patients, Referred for Psychiatric Consultation

Abstract

Background: To assess by Liaison Psychiatry the pattern of psychiatric co-morbidity in referred medical and surgical in-patients in a tertiary care hospital. Methods: This was a descriptive study, conducted at Department of Psychiatry, out-patient services in Fauji Foundation Hospital, Rawalpindi. One hundred consecutive hospitalized patients referred to Department of Psychiatry from Medical and Surgical Units of Fauji Foundation Hospital were enrolled in the study during a period of seven months. A semi structured proforma was used for collection of demographic data and detailed information regarding reasons of psychiatric referral along with current medical and surgical complaints. Results: Mean age of the sample was 39.9 years, 77% of the patients were female and majority of the patients, 62% were married. All the patients belonged to either poor class (61%) or lower middle class (39%). Professional categories showed house wives (54%) comprising the major group and 25% were students. Majority of the patients, 56% were referred from medical departments and the main reason for referral was medically unexplained physical symptoms (36%) of one hundred consultations. General Health Questionnaire 12 (GHQ-12) screened 89% of cases with psychiatric co-morbidity as compared to 11% non cases without psychiatric symptomatology. Majority (51%) of the patients had diagnosis of depressive episode, mild moderate or severe and 19% of the patients had dissociative (conversion) disorder as the second commonest diagnosis. Conclusions: There is generally a low referral rate despite significant psychiatric morbidity among medical and surgical in-patients. Further studies should be conducted in the field of liaison psychiatry to address other variables such as length of hospital stay, use of laboratory investigations and pattern of prescription medicines.