Consultation-liaison psychiatry and psychosomatic medicine: the company they keep

The objectives of this review are 1) to briefly describe the parallel historical developments of consultation-liaison (C-L) psychiatry and psychosomatic medicine [corrected]; 2) to analyze the extent to which the literature of C-L psychiatry and psychosomatic medicine relate to each other, given that both fields have evolved simultaneously in the history of psychiatry; and 3) to propose possible explanations for observed publication patterns in selected C-L resources and the journal Psychosomatic Medicine.

The quasi-citation analysis includes two segments: 1) a review of selected key C-L psychiatry references to determine the extent to which classic articles from Psychosomatic Medicine are cited; and 2) an analysis of 60 years of Psychosomatic Medicine, sampling issues from the first 5 years of each decade and all issues of the year 2000 for articles of potential relevance to C-L psychiatry. References to Psychosomatic Medicine articles in C-L resources are tallied as percentages of total references in each source. Articles in Psychosomatic Medicine are assigned to one of three categories (A, B, or C) according to their perceived relevance to C-L psychiatry, from most (A) to least (C) relevant.

The review of C-L sources ("basic" reading lists and reference lists of seminal articles and textbooks) revealed a wide range of Psychosomatic Medicine citations, from 0% to 27.4% (average, 7.5%). The survey of Psychosomatic Medicine sorted 1705 articles for their relevance to C-L psychiatry into category A (9.5-40.6%, average 21.3%), category B (70.4-86.3%, average 72.3%), and category C (0.7-12.1%, average 6.4%) for each half-decade for the past 60 years. The lowest number of category A articles appeared in the years 1970 to 1975, and the highest number appeared in 1950 to 1955; reciprocal results were found for category B articles. The lowest number of category C articles appeared in 1980 to 1985, and the highest number appeared in 1940 to 1945. For the six issues of 2000, the distributions of articles in categories A, B, and C are similar, continuing an upward trend beginning in 1975 of core (category A) articles. Explanations for publication patterns are speculatively related to various factors, such as a paucity of C-L research and researchers, the broad definition of C-L psychiatry, editorial policies, and the impact of World War II.

Although C-L psychiatry and psychosomatic medicine have common roots, the reliance of the C-L literature on classic Psychosomatic Medicine articles has varied markedly, from none to about one-quarter of its references. Nevertheless, Psychosomatic Medicine has consistently published articles of theoretical and clinical interest to C-L psychiatrists, with more than 90% of published articles considered to be of high or moderate relevance to C-L psychiatry. A far higher percentage of articles in Psychosomatic Medicine would seem to be relevant to the field of C-L psychiatry than are cited in significant C-L literature. Psychosomatic Medicine's essential focus on empirical research may dissuade the more clinically oriented C-L psychiatrists.