• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.98-106
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• 1994

The authors investigated 131 nonpsychiatric physicians' attitudes toward psychiatric consultation, using questionnaires. A comparison was made as regards psychiatric consultation from nonpsychiatric physicians over position(staffs vs. residents) and department(medical vs. surgical). These findings are as follows ; 1) 51.9 percent of nonpsychiatric physicians estimated that less than 30 percent of their patientshadpgychiatricproblems. 2) The percentage of the patients referred for psychiatric consultation were 30 or less than 30 percent 3) Staffs tried to refer their patients to psychiatric department for psychiatric consultation more frequently than residents. 4) Medical physicians tried to refer their patients to psychiatric department for psychiatric consultation more frequently than surgeons. 5) Psychiatric consultation was estimated to be most frequently requested for overt psychiatric symptoms(23.0%) and past history of psychiatric treatment(20.8%). 6) The most frequent causes of not referring to department of psychiatry were found to be the patients' rejection(46.8%) and non-psychiatric physicians' dissatisfaction with the results of consultation (22.2%). 7) Medical physicians tended to explain the reasons for psychiatric consultation more adequately than surgeons. 8) Residents more specifically wrote the reasons for psychiatric consultation on the chart than staffs. The results suggest that staffs are more active in psychiatric consultation than residents, whereas medical physicians are more active than surgeons. Thus, education should be more emphasized for surgeons and residents, especially for the latter for effective consultation-liaison activity. On the other hand, psychiatrists should try to improve nonpsychiatric physicians' dissatisfactions with the results of psychiatric consultations, which will positively change their attitudes toward psychiatric consultation.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.1
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• pp.46-58
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• 1998

Objectives : This study was performed to evaluate the status of psychiatric consultation at a newly opened university hospital, to explore problems related to psychiatric consultation and to contribute for future consultation to be more systematic and more efficient. Methods: The subjects of this study were 284 patients hospitalized at Inha University Hospital between September 1, 1996 and August 31, 1997, who were referred for psychiatric consultation during hospitalization. This study was evaluated demographical characteristics of referred patients, resons for referral, recommendations by psychiatric consultant, clinical diagnoses, psychiatric diagnoses, relationship between referral time and hospitalization following the day of consultation and consultation referral types based upon psychiatrists' reports and patients' medical charts. Results : Most common patients referred to consultation were females aged 20s who visited at the department of internal medicine and related to the risk of suicidal attempts. Mood disorder was the most frequent psychiatric diagnosis, and the most common recommendations were to use psychopharmacological treatment along with outpatient visits. The 30% of subjects were referred to consultation within a day after hospitalization. In the case of consultation referral timing within two days and after three days, there was significant difference between early consultation and shorter hospitalization following the day of consultation. Most frequent type of consultation(29.6%) was categorized as IIIa type(physical complication type as a "Mending" request type). Conclusion : In review of consultation referral timing and consultation referral type of the subjects, who were referred for psychiatric consultation for one year at a newly opened University Hospital, referrals were found to be made within two days after their admission to hospital(50.7%), which was observed to be early request. We found that there was significant association between early consultation and shorter hospitalization following the day of consultation. The physical complication type(29.6%) which belongs to "Mending" request type was found to be the most frequent consultation referral type. This result indicates that more systematic psychiatric consultation is needed for the future.

• Korean Journal of Psychosomatic Medicine
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• v.6 no.2
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• pp.176-187
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• 1998

This study was performed to identify the significant variables affecting Follow-up after psychiatric consultation in General medical units and the trends of psychiatric consultation at the Hallym University hospital in Chunchon. Subjects of this study were 107 patients from April 1, 1998 to August 31, 1998, who were referred for psychiatric consultation during hospitalization. The results were as follows ; 1) Referral rate of General medical units was 7.5% and ordered Gastroenterology, Cardiology, nephrology, Other part. 2) The rate of total follow-up was 58% and the rate of No-follow-up was 42%. 3) In the cases of referral timing over admission 8th days, the days hospitalized after consultation performed were lengthened, significantly. 4) Common reasons for no follow-up of consultation were 'early- discharge' and 'patient's unwillingness to psychiatric reconsult. 5) Significant variables affecting follow-up were 'treatment recommendation', 'concordance with psychiatric drug recommendation', 'concordance with laboratory recommendation', 'total days hospitalized', 'Days hospitalization after consult was performed' and 'referral reason'.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.75-80
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• 1993

To understand and evaluate the patients who were referred for psychiatric consultation from medical departments, the authors reviewed the concept of disease, psychological reaction to disease, problems on psychiatric diagnosis and evaluation which were encountered at the medical ward. In addition, we reviewed what psychiatrists should do during consultation.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.81-91
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• 1993

The consulting internist will encounter patients with psychiatric symptoms and those who take psychotropic medications in many settings. The internist must loam to feel comfortable interacting with patients who display psychiatric symptoms. while maintaining an open and unprejudiced attitude toward their evaluation. The proper delineation of psychiatric disorders from normal emotional reactions resets on a careful history, a mental status evaluation. and a knowledge of psychiatric syndromes. Many physicians tend erroneously to view behavioral changes only in a psychological framework Abrupt changes in behavior, personality, mood. or ability to function should be evaluated for possible organic causes. Then, the internists should take their consultation to psychiatrists and freely discuss psychologic problems of the patients.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.1
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• pp.25-30
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• 2008

With the rapid growth of geriatric population, geriatric psychiatric consultation has come to play a more important role in recent years. It is necessary to find out characteristics of psychiatric consultation-liaison in elderly and applicate practical guideline of consultation in medical setting. Management of medically ill elderly in psychiatric consultation requires different guideline from that of other age group patient. Because aging and each organ-specific diseases change the pharmacokinetics of psychotropic drugs variably. These pharmacokinetic changes should be considered in psychosomatic treatment in medically ill elderly. The relatively low consultation rates for psychiatric disorders in the elderly indicate that research is needed into factors that both prevent and facilitate elderly patients with psychological symptoms from consulting their general practitioners.

• Korean Journal of Psychosomatic Medicine
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• v.1 no.1
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• pp.98-100
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• 1993

To become an effective and successful consultation-liasion psychiatrist the psychiatrist should consider two aspects of consultation before he/she meets his/her patients. First the psychiatrist should understand the internal need and psychological state of patients who visited their physician before being refered to a psychiatrist So psychiatrists should be careful in the evaluation of the patient's intention whether they are willing to accept the psychiatric treatment approach or not Second the psychiatrist should understand the situation and the physician's internal need in the consultation. Psychiatrists should recognize whether there are any factors which interfere with the mutual understanding and cooperation between physicians and psychiatrist.

• 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.

• 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.