Psychiatric consultation at Srinagarind Hospital: a report on 271 cases

The author reviewed psychiatric consultations at a teaching general hospital over a two year period. Two hundred and seventy-one patients or 0.6 per cent of all admission were referred for psychiatric consultation. The referral rate from the medical and surgical departments were higher than that of other departments. The most common psychiatric diagnosis by psychiatric consultants was delirium, followed by adjustment disorder and mood disorders. The delirious patients were significantly older than the other groups. The delirious state was commonly caused by infectious diseases, diseases of the nervous system and sense organs and disorders of fluid, electrolyte and acid-base balance. Most of the patients who had two or more active medical problems would have greater incidence of delirium. The delirious patients tended significantly to have behavior that disturbed the therapeutic environment. Among the functional psychiatric disorder patients, 22.4 per cent manifested suicide attempts as the principal reason for admission to non-psychiatric wards. The study revealed that the consultee could give the proper psychiatric diagnosis in only 18.3 per cent of the delirious group, 21.2 per cent in other organic mental disorder group and 24.6 per cent in functional psychiatric disorder group. Most of the consultees described only the psychiatric symptoms of the referred patients and did not specify the psychiatric diagnosis. The most frequently stated reason for psychiatric consultation was for proper evaluation and management.