• Title/Summary/Keyword: 자문의뢰

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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Nutritional Status of Intensive Care Unit Patients According to the Referral to the Nutrition Support Team and Compliance with the Recommendations (영양집중지원팀 자문 의뢰 및 순응 여부에 따른 중환자실 환자의 영양상태 비교)

  • Sohn, Yunjin;Hyun, Taisun
    • Korean Journal of Community Nutrition
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    • v.27 no.2
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    • pp.121-131
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    • 2022
  • Objectives: This study aimed to examine the effectiveness of the intervention of the nutrition support team (NST) on the nutritional status of critically ill patients. Methods: The medical records of 176 adult patients who were admitted to the intensive care unit and received enteral or parenteral nutrition for more than 7 days were retrospectively analyzed. The patients were classified into the NST and non-NST groups according to whether they were referred to the NST or not. The NST group was further classified into the compliance and non-compliance groups depending on their compliance with the NST recommendations. Results: The NST referral rate was 56.8%, and the rate of compliance with the NST recommendations was 47.0%. Significantly higher energy and protein were provided to the NST and the compliance groups than to the non-NST and the non-compliance groups. The proportion of patients who reached the target calories after the initiation of enteral nutrition was significantly higher in the NST and the compliance groups than in the non-NST and the non-compliance groups. The serum albumin and hemoglobin levels significantly decreased in every group, but the changes were significantly lower in the compliance group. The nutritional status at discharge from the intensive care unit compared to the status at admission was significantly worse in the NST, non-NST, and non-compliance groups. However, the status was maintained in the compliance group. The length of stay in the intensive care unit was significantly shorter in the compliance group. Conclusions: Compliance with the NST recommendations was found to provide more calories and protein and prevent the deterioration of the nutritional status of critically ill patients. Therefore, effective communication between medical staff and the NST from the early stages of admission to the intensive care unit is needed to improve referrals to the NST and compliance with the recommendations.

Clinical Characteristics and Use of Psychotropic Agents among HIV-Infected/AIDS Patients Referred for Psychiatric Consultation (일 병원 정신건강의학과로 자문의뢰 된 HIV 감염/후천성면역결핍증 환자의 임상적 특성과 향정신약물 사용)

  • Shin, Sang-Ho;Kim, Hyun-Chung;Yoo, So-Young;Shin, Hyoung Shik;Won, Sung-Doo;Lee, So Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.31-39
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    • 2014
  • Objectives : This study aimed to investigate the psychiatric status of HIV-infected/AIDS inpatients in a general hospital over the past 2.5 years. Methods : A retrospective chart review was conducted of psychiatric consultations performed between January 1, 2011, and July 30, 2013. The records of 97 HIV-infected/AIDS patients were analyzed. These included a total of 282 psychiatric consultations. Results : Of the 97 patients, 91(93.8%) were male, the mean age was 48 years, and mean number of consultations was 2.8. Depressed mood was reported in 102 consultations(23.8%), insomnia in 60(14.0%), and anxiety in 31(7.2%). Psychiatric disorders diagnosed on initial consultation included depressive disorder(37 patients ; 37.0%), cognitive disorder(11 ; 11.0%), and delirium(9 ; 9.0%). Recommended psychotropic medication included Lorazepam(99 ; 17.2%), Escitalopram(90 ; 15.7%), and Quetiapine(84 ; 14.6%). Conclusions : The main complaints of HIV-infected/AIDS patients were depressed mood, insomnia, and suicidal ideation(including suicide attempts). In total, 85(93.3%) patients of those consulted were diagnosed as meeting the criteria for a psychiatric condition. However, considering that only 16.9% of patients consulted received follow-up treatment, longitudinal research is needed to examine the influence of psychiatric disorders on the transmission of HIV-infection/AIDS, as well as on prognosis and treatment adherence.

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PSYCHIATRIC CONSULTATION IN A CHILDREN'S HOSPITAL (소아병원에서의 정신과 자문)

  • Lee, Young-Sik;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.108-116
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    • 1990
  • Child Psychiatric consultations on 92 patients hospitalized at the Seoul National Childrens Hospistal were analyzed retrospectively. The main referral sources were Pedictrics(77.2%), Neurosurgery(8.91%) and Orthopedics(3.96%) Consultation rate was 0.81% for the Hospital, 1.41% for Department of Pediatrics, 3.54% for Neurosurgery and 0.3% for the other department were made for the differential diagnosis raher than for the treatment or intervention. The diagnosis of referred patients were somatoform disorder(25%), organic mental disorder(18.5%), developmental disorder(14.1), conduct disorder(6.5%), anxiety disorder(6.5%).

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A Study on the Characteristics and Consultation Type of Inpatients Referred for Delirium and Depressive Disorder (섬망 및 우울장애로 자문 의뢰된 입원환자의 임상적 특징 및 의뢰 형태에 관한 연구)

  • Seong min Lee;Seung-Ho Ryu;Jee Hyun Ha;Hong Jun Jeon;Doo-Heum Park
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.10-18
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    • 2023
  • Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations (청소년 정신과 입원 환자들의 피부과 자문 의뢰에 관한 행태 분석 및 고찰)

  • Kwon, Hyunjung;Jo, Hyunyoung;Kim, Youngil;Park, Kyungduck;Chung, Hyun;Park, Joonsoo
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.1
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    • pp.20-25
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    • 2015
  • Objective:To review the patterns of the dermatologic consultations of psychiatric adolescent inpatient and to explore the relationship between the dermatologic disorders and psychiatric disorders. Methods:We retrospectively studied the data from 22 cases referred by psychiatric adolescent for a dermatologic consultation over 10 years in Daegu Catholic University Medical Center and compared with the data from 108 cases referred by the other department adolescent patients. Results:The mean age of patients was 15.9. The male to female ratio was 1:1.44. The most common psychiatric and dermatologic disorder was major depressive disorder and acne, respectively. The most frequent reason for consultation was to ask for dermatologic disease or condition(54.5%) followed by to perform cosmetic procedure of patients need(40.9%) and to perform dermatologic test(4.6%). Conclusions:More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient. Increased understanding of biopsychosocial approaches and liaison among psychiatrists and dermatologists could be beneficial.

A CLINICAL STUDY OF CHILD AND ADOLESCENT PSYCHIATRIC CONSULTATION IN A GENERAL HOSPITAL (종합병원 소아정신과에 자문의뢰된 환아에 대한 임상적 고찰)

  • Kim Yeoung-Rang;Hong Sungdo D.;Lee Sang-Sin;Lim Seong Hu;Park Jeoung Hwan
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.72-78
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    • 2005
  • Objectives : This study is to investigate the clinical characteristics of psychiatric consultation for children and adolescents in a general hospital. Methods : Hospital records of 302 children and adolescents who were referred for psychiatric consultation in a general hospital over 4 years were reviewed and analyzed. Results : The mean referral rate for psychiatric consultation for school age children and adolescents was $2.15\%$. While more girls were referred in middle and high school age group, more boys were referred in pre-school age group. Fifty percent of the consultation was requested from department of internal medicine and pediatrics. Main reason for requesting psychiatric consultation was fur the assessment of the patients from psychiatric point of view $(31.1\%)$, followed by the management of depression $(11.6\%)$ and anxiety $(11.3\%)$. Most frequently rendered psychiatric services for the treatment was psychosocial education and supportive therapy $(21.2\%)$. Conclusion : There are differences in clinical nature of psychiatric consultation and referral patterns between adult patients and child and adolescent patients. Future research is needed to strengthen the services for child and adolescent psychiatric consultation.

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Psychiatric Consultation for 5 Years in a University Hospital (일 대학병원에서 5년간 시행된 정신과 자문의뢰 분석)

  • Kim, Sung-Wan;Kim, Seon-Young;Kim, Sung-Jin;Kim, Jae-Min;Shin, Il-Seon;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.1
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    • pp.28-33
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    • 2011
  • Objective: This study aimed to investigate the pattern of psychiatric consultation-liaison in a new general hospital over a 5-year period. Method: Retrospective chart review was conducted for psychiatric consultations performed from May 2004 to December 2008 in a new general hospital in Hwasun, Korea. Results: A total of 1,852 patients who were referred to the Department of Psychiatry for consultation were included in the analysis. The main reasons for psychiatric consultation were changes in mental status(20.5%), depression(16.8%), insomnia(12.8%), and anxiety(7.9%). Psychiatric consultations were conducted with diagnoses of delirium(39.7%), depressive disorder(28.2%), adjustment disorder(7.9%), and anxiety disorder(4.1%). Patients with delirium were significantly older than were those with other psychiatric diagnoses(p<0.001). Delirium was more common in male patients than in female patients(47.1% vs. 29.9%, respectively), and depression was more common in female patients than in male patients(48.3% vs. 33.9%, respectively)(p<0.001). Delirium was more common in patients who underwent surgical operation than those who did not(p=0.010). Conclusion: Delirium was the most common diagnosis for psychiatric consultation followed by depression in a university hospital. Delirium was more prevalent in men than in women, while depression was more common in women.

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The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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A Study on the Characteristics and Consultation Request Type of Inpatients Referred for Depressive Symptoms (우울 증상으로 의뢰된 입원환자의 임상적 특징 및 자문 의뢰 형태에 관한 연구)

  • Yoon, Nara;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.1
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    • pp.34-41
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    • 2021
  • Objectives : The purpose of this study is to investigate the characteristics of depressive patients who admitted to general hospital. We examined the clinical characteristics of patients who were referred to the Department of Psychiatry as depressive symptoms, according to the type of consultation request, and comparing 'with re-consultation' and 'without re-consultation' groups. Methods : We performed a retrospective chart review of 4,966 inpatients who were referred to the Department of Psychiatry from August 2005 to December 2011. Results : For about 6 years, among the inpatients referred for psychiatric consultation, a total of 647 patients were referred for depressive symptoms, accounting for 13.82% of the total consultations. The average age of depressive patients was 58.6 years, which was higher than the average of 56.4 years of overall patients. Among the depressive patients, 275 patients were included in 'with re-consultation' group and there was no statistically significant difference when comparing 'with re-consultation' group and 'without re-consultation' group. However, there was a difference in the tendency of the two groups in the type of consultation request. 'With re-consultation' group was in the order of frequency of consultation type 3-2-1, whereas the 'without re-consultation' group was in the order of frequency of consultation type 2-3-1. Conclusions : The group of inpatients who were referred for depressive symptoms in general hospital showed the largest proportion of the group of patients referred to the Department of Psychiatry. 'With re-consultation' group had a higher rate of re-consultation due to the occurrence of new symptoms after hospitalization compared to 'without re-consultation' group. Therefore, doctors in each department and psychiatrists should pay attention to the depressive symptoms of inpatients and actively discuss treatment plans to improve the quality of medical services, identify risk factors, and make efforts to intervene early if necessary.