Challenges, problems, and opportunities in consultation-liaison psychiatry research

While consultation-liaison (C-L) psychiatry has blossomed as a psychiatric sub-specialty, C-L research remains relatively underdeveloped. Individual case reports or else small series studies predominate. In contrast, relatively few studies are hypothesis-driven, experimental, or include design features such as blinding or randomization. Now that the field has matured, it is ready for such studies. Aside from the fact that developing fields require time to develop a research infrastructure, another reason for the lag in consultation-liaison research is the distraction with other issues such as the continuing debate between advocates of consultation vs liaison, competition with behavioral medicine practitioners, and the quest for formal sub-specialization status. Unless the development of a firm research base is equally emphasized, one worries about the longterm intellectual development of this important area.