Referral patterns for psychiatric consultation in a large general hospital

Referrals for psychiatric consultation from all inpatient and outpatient departments in a large general hospital were analysed. There were 597 referrals--the combined inpatient and outpatient referral rate was approximately 0.78% and the inpatient rate 1.8%. The most common reasons for referral were parasuicide, depression/symptoms of depression, abnormal behaviour and alcohol abuse. Depressive disorders, drug dependence and neuroses were the most common diagnoses made. Medication was prescribed in 38% of cases and psychotherapy was offered in 18%. In 21% of cases the patient was either managed in his original ward or transferred back to the ward with advice regarding management. In 79% of cases management was within the Department of Psychiatry; many of these patients required concurrent treatment from the referring doctor for a physical disorder. The value of improving the quality and availability of consultation-liaison psychiatry services is discussed.