Establishing a consultation-liaison psychiatry service. Impact on clinical indices

OBJECTIVE: To show prospectively the impact of establishing a consultation-liaison (C/L) psychiatry model on the consultation clinical indices.

METHODS: A structured, organized model of C/L psychiatry was established in 1990 at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia and all clinical indices of the psychiatric consultations were compared prospectively over the first 3 years after January 1990 with those over the previous 2 years retrospectively before January 1990.

RESULTS: Three hundred and two patients were referred over 3 years after January 1990, group A and 99 patients were referred over the 2 years before January 1990, group B and the male to female ratio were similar in both groups 1:1.99 and 1:2.1. Referred cases were found more to be females, married and living in urban areas and referred from the Department of Medicine. Positive influences of establishing the C/L service were; nearly double rate of referral, more selectivity of cases, more referred cases for assessment of competence and with past psychiatric history, and more patients referred with informed consent. Depressive disorder was more common in both groups.

CONCLUSION: A well structured C/L psychiatry model, with clearly defined aims, has had a definite positive impact on the clinical indices of the psychiatric consultations promoting close cooperation for the excellence of patient care. This opens room for future research to explore specific developments in proposed models of C/L psychiatry.