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Need and utilization of psychiatric consultation services among general hospital inpatients

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Abstract

Objective

The aim of the present study was to estimate the need for psychiatric consultation services and psychiatric inpatient referral among inpatients of non-psychiatric hospital departments, and to assess the actual utilization of these services.

Methods

The study was carried out among 728 inpatients of physical rehabilitation wards, medical, surgical, and gynecological wards in Austrian hospitals. Psychiatric case identification was performed by research psychiatrists using the Clinical Interview Schedule (CIS). Diagnoses were given according to DSM-III-R. The assessment of need for consultation and inpatient referral was based on the clinical judgments of research psychiatrists.

Results

Overall, 34.2% of the inpatients were cases according to the CIS-criteria, 51.8% of them needing either psychiatric consultation or inpatient referral according to research psychiatrists. In 66.7% of those for whom research psychiatrists had stated a need, this need was not met (“unmet need”), while only 33.3% of them had their need met. In contrast, a psychiatric consultation was performed among 5% of those patients not needing psychiatric services according to the research psychiatrists (“overprovision”). Variables of the health care system (i.e. department type and catchment area of the hospital) were among the predictors for “met needs”.

Conclusion

The rate of actual psychiatric consultations and admissions to psychiatric wards was markedly lower than the need according to research psychiatrists’ judgment.

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References

  1. Härter M, Woll S, Wunsch A, Bengel J, Reuter K (2004) Recognition of psychiatric disorders in muskuloskeletal and cardiovascular rehabilitation patients. Arch Phys Med Rehab 87:192–197

    Google Scholar 

  2. Johnston M, Wakeling A, Graham N, Stokes F (1987) Cognitive impairment, emotional disorder and length of stay of patients in a district general hospital. Br J Med Psychol 60:133–139

    PubMed  Google Scholar 

  3. Fink P, Hansen MS, Sondergaard L, Frydenberg M (2003) Mental illness in neurological patients. J Neurol Neurosurg Psychiatry 74:817–819

    Article  CAS  PubMed  Google Scholar 

  4. Millar HR (1981) Psychiatric morbidity in elderly surgical patients. Br J Psychiatry 139:17–20

    Google Scholar 

  5. O’Donell K, Chung JY (1997) The diagnosis of major depression in end-stage renal disease. Psychother Psychosom 66:38–43

    Google Scholar 

  6. Ortega AN, McQuaid EL, Canino G, Ramirez R, Fritz GK, Klein RB (2003) Association of psychiatric disorders and different indicators of asthma in island Puerto Rican children. Soc Psychiatry Psychiatr Epidemiol 38:220–226

    Article  PubMed  Google Scholar 

  7. Desai RA, Rosenheck RA, Agnello V (2003) Prevalence of Hepatitis C virus infection in a sample of homeless veterans. Soc Psychiatry Psychiatr Epidemiol 38:396–401

    PubMed  Google Scholar 

  8. Seltzer A (1989) Prevalence, detection and referral of psychiatric morbidity in general medical patients. J R Soc Med 82:410–412

    CAS  PubMed  Google Scholar 

  9. Maguire GP, Julier DL, Hawton KE, Bancroft JHJ (1974) Psychiatric morbidity and referral on two general medical wards. Br Med J 1:268–270

    CAS  PubMed  Google Scholar 

  10. Bebbington PE (1990) Populations surveys of psychiatric disorder and the need for treatment. Soc Psychiatry Psychiatr Epidemiol 24:173–178

    Google Scholar 

  11. Goldberg D, Huxley P (1992) Common mental disorders: a bio-social model. Routledge, London-New York

    Google Scholar 

  12. Arolt V (1997) Psychische Störungen bei Krankenhauspatienten. Springer, Berlin, Heidelberg

    Google Scholar 

  13. Strain JJ, Hammer JS, Fulop G (1994) APM Task Force on psychosocial interventions in the general hospital setting: a review of cost-offset studies. Psychosomatics 35:253–262

    CAS  PubMed  Google Scholar 

  14. Goldberg DP, Cooper B, Eastwood MR, Kedward HB, Shepherd M (1970) A standardized psychiatric interview for use in community surveys. Br J Prev Soc Med 24:18–23

    CAS  PubMed  Google Scholar 

  15. Cooper B, Schwarz R (1982) Psychiatric case identification in an elderly population. Soc Psychiatry 17:43–52

    Google Scholar 

  16. Cooper B (1978) Probleme der Falldefinition und Fallfindung. Nervenarzt 49:437–444

    CAS  PubMed  Google Scholar 

  17. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders, 3rd edn. Washington DC: American Psychiatric Association Revised

    Google Scholar 

  18. Fichter MM (1990) Verlauf psychischer Erkrankungen in der Bevölkerung. Springer, Berlin, Heidelberg, New York

    Google Scholar 

  19. Wancata J, Gössler R (1999) Die konsiliarpsychiatrische Versorgung in Österreich. In: Diefenbacher A (Hrsg): Aktuelle Konsiliarpsychiatrie und –psychotherapie. Georg Thieme Verlag, Stuttgart New York, pp 177–195

  20. SPSS (1990) The statistical package for IBM-PC. SPSS Inc, Chicago

    Google Scholar 

  21. Wancata J, Benda N, Hajji M, Lesch OM, Möller C (1996) Psychiatric disorders in gynecological, surgical and medical departments of general hospitals in an urban and a rural area of Austria. Soc Psychiatry Psychiatr Epidemiol 31:220–226

    Article  CAS  PubMed  Google Scholar 

  22. Wancata J, Benda N, Hajji M (1998) Prävalenz und Verlauf seelischer Erkrankungen an internen Krankenhausabteilungen. Wien Klin Wochenschr 110:597–603

    CAS  Google Scholar 

  23. Wancata J, Benda N, Bach M, Meise U (2000) Recognition of psychiatric disorders in nonpsychiatric hospital wards. J Psychosomat Res 48:149–155

    Article  CAS  Google Scholar 

  24. Hansen MS, Fink P, Frydenberg M, Oxhoj M-L, Sondergraard, Munk-Jorgensen P (2001) Mental disorders among internal medical inpatients: prevalence, detection, and treatment status. J Psychosom Res 50:199–204

    Article  CAS  PubMed  Google Scholar 

  25. Hengleveld MW, Ancion F, Rooijmans H (1987) Prevalence and recognition of depressive disorders in general medical inpatients. Int J Psychiatry Med 17:341–348

    Google Scholar 

  26. Bickel H, Cooper B, Wancata J (1993) Psychische Erkrankungen von älteren Allgemeinkrankenhauspatienten: Häufigkeit und Langzeitprognose. Nervenarzt 64:53–61

    CAS  PubMed  Google Scholar 

  27. Wancata J, Benda N, Meise U, Müller C (1998) Use of psychotropic drugs in gynecological, surgical and medical wards of general hospitals. Int J Psychiatry Med 28:303– 314

    CAS  Google Scholar 

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Correspondence to Monika Krautgartner.

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Krautgartner, M., Alexandrowicz, R., Benda, N. et al. Need and utilization of psychiatric consultation services among general hospital inpatients. Soc Psychiat Epidemiol 41, 294–301 (2006). https://doi.org/10.1007/s00127-005-0025-z

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