Patterns of Psychiatric Referrals in a Consultation-Liaison Setting at a Rural Tertiary Care Center in Central India.

INTRODUCTION

Consultation-liaison psychiatry (CLP) addresses psychiatric symptoms in patients referred from non-psychiatric departments. This study examined the socio-demographic, clinical, and referral profiles of such patients in a rural tertiary care medical institution in central India.

MATERIALS AND

METHODS

All patients referred to the psychiatry department over a two-month period were included. Data on demographics, referral patterns, and diagnoses were collected using a structured proforma and analyzed descriptively with 95% confidence intervals (CI).

RESULTS

Of the 200 patients included in the study, 151 patients (75.5%, 95% CI: 69.1-80.9) were referred from inpatient settings. The general medicine department contributed the majority of referrals, accounting for 162 cases (81.0%, 95% CI: 75.0-85.8). The most frequent medical diagnosis among referred patients was poisoning, reported in 78 cases (39.0%, 95% CI: 32.5-45.9), followed by alcoholic liver disease in 15 cases (7.5%, 95% CI: 4.6-12.0). The most common reasons for psychiatric referral were self-harm behavior in 80 patients (40.0%, 95% CI: 33.4-46.9), multiple unexplained physical symptoms in 25 patients (12.5%, 95% CI: 8.6-17.8), and alcohol withdrawal and de-addiction in 23 patients (11.5%, 95% CI: 7.7-16.7). The leading psychiatric diagnoses included major depressive disorder in 28 patients (14.0%, 95% CI: 9.9-19.5), adjustment disorder in 25 patients (12.5%, 95% CI: 8.6-17.8), acute stress reaction in 25 patients (12.5%, 95% CI: 8.6-17.8), delirium in 20 patients (10.0%, 95% CI: 6.5-14.9), and somatoform disorder in 11 patients (5.5%, 95% CI: 3.1-9.6). Regarding management, 87 patients (43.5%, 95% CI: 36.8-50.4) received pharmacological treatment alone, while 83 patients (41.5%, 95% CI: 34.9-48.4) were treated with both pharmacological and non-pharmacological approaches. Follow-up adherence was noted in 75 patients (37.5%, 95% CI: 31.0-44.4).

CONCLUSION

Despite significant psychiatric morbidity, referral rates remain low. Strengthening CLP services and improving psychiatric training among non-psychiatric clinicians are essential, especially in rural and resource-constrained settings.