Patterns of psychiatric consultation in an Austrian tertiary care center - results of a systematic analysis of 3,307 referrals over 2 years.

OBJECTIVE: The purpose of this study was to investigate the phenomenology of a newly structured Austrian tertiary - care hospital consultation - liaison (C - L) psychiatry service.

SUBJECTS AND METHODS: We compared two 1 - year surveys over two years of observation (2003 - 2005). Survey A (August 1, 2003, until July 31, 2004) comprised 1474 consecutive new consultations, and the more recent Survey B (August 1, 2004, until July 31, 2005) extended over 1833 consecutive new referrals to our C - L service. Psychiatric referrals were analyzed with regard to consultation rate, demographic characteristics, referring departments, principal reasons for referral, diagnostic characteristics, and intervention patterns.

RESULTS: The consultation rate increased by 0.61% from 2.69% in Survey A to 3.30% in Survey B. Internal medicine consistently accounted for almost 31% of all referrals in both surveys. In Survey A, the most common psychiatric diagnoses were adjustment disorders (21.4%), depressive disorders (18.5%), and delirium (18.1%). The most prevalent diagnoses in Survey B were adjustment disorders (24.5%), delirium (18.8%), and depressive disorders (14.3%). Pharmacotherapy was the most frequent action in both surveys and accounted for between 45% and 49% of all actions.

CONCLUSION: This study underscores the need for specially planned C - L services in Austria that provide both psychiatric and psychosocial care for patients who are medically ill.