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CONSULTATION-LIAISON

PSYCHIATRY

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Consultation-Liaison Psychiatry

It is the study, practice andteaching of the relation

between medical and

psychiatric disorders.

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C-L Psychiatrists

serve as consultants to medicalcolleagues (either another psychiatrist or,more commonly, a nonpsychiatric

physician) or to other mental health professionals

(psychologist, social worker, or psychiatricnurse)

consult regarding patients in medical orsurgical settings and provide follow-uppsychiatric treatment as needed

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Roles of a C-L Psychiatrist

skillful and brief interviewer

good psychiatrist and psychotherapist

teacher

knowledgeable physician who

understands the medical aspects of the

case

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C-L Psychiatry

Associated with all the diagnostic,

therapeutic, research and teaching

services that psychiatrists perform in thegeneral hospital and serves as a bridge

between psychiatry and other specialties.

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SCOPE

1. Understand the impact of medical illness andthe system in which it is treated and how thisaffects the presentation, experience, and impactof psychiatric and psychosocial morbidity.

2. Conduct a biopsychosocioculturalassessment, create a formulation and implementappropriate treatment in the context of thegeneral hospital including effectivecommunication with the rest of the treatmentteam.

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3. Assess reactions to illness, anddifferentiate the presentation of depression

and anxiety in the medical setting.

4. Understand the trajectories of illness

and the developmental issues of the

person with mental health problems and

mental illness.

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7.Understand the particular needs ofspecial populations with psychiatric andpsychosocial morbidity in the medicalsettings, including the young, the old, theindigenous, and those with intellectualdisabilities.

8. Assess and manage acute and

emergency presentations of psychiatricmorbidity in the general medical setting.

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C-L Psychiatrists

Treat psychiatric problems in medical

patients.

Commonly treated problems: anxiety,

sleep disorders, disorientation, often as a

result of delirium.

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Recommend specific medications

Identify and organize the patient's social cupportsystems

Address the immediate problem through short-term, dynamic psychotherapy

Develop a plan to deal with the petient's socialor occupational problems

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COMMON CONSULTATION-

LIAISON PROBLEMS

1. SUICIDE ATTEMPT OR THREAT

2. DEPRESSION

3. AGITATION

4. HALLUCINATIONS

5. SLEEP DISORDER

6. CONFUSION

7. NONCOMPLIANCE OR REFUSAL TOCONSENT TO PROCEDURE

8. NO ORGANIC BASIS FOR SYMPTOMS

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PROBLEMS IN HOSPITALIZED

MEDICAL PATIENTS Resistance to treatment for medical

complications of substance abuse

Chronic psychiatric illness in a patient admittedfor other reasons

Medical complications of psycotropic agents

Medical complications of a suicide attempt

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PATIENTS AT RISK

Patients with AIDS

Patients undergoing renal dialysis

Patients undergoing surgery

Patients treated in the ICU

Transplantation issues

Psychooncology

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THANK YOU :-)