Psychiatric consultation in a general hospital

The psychiatrist's role in the therapeutic management of a wide range of hospitalized persons is now recognized. This study investigated the extent and the pattern of consultations among the medical specialties (medicine, surgery, obstetrics/gynecology, family practice, pediatrics and psychiatry) in a large teaching hospital over a one year period. Among the specialties consultations were requested most often from within the same specialty; for example, medicine sought 64.4% consults from medicine. The proportion of patients with an associated psychiatric diagnosis in each of the specialties ranged from 2 to 21%. Psychiatric consultations on these patients ranged from 5 to 13 per hundred (medicine = 12, surgery = 8.9, family practice = 13.2 and pediatrics = 5). Consultations rates reported in previous studies were also reviewed. Factors that may contribute to the generally low rate of psychiatric consultation and the implications for providing better care are then discussed.