Objective: To describe the concordance of the consultees with the Consultation-Liaison Psychiatry Services recommendations and diagnosis. Methodology: Review of 138 medical records of patients referred to the CL Psychiatry Service between January-December 2000 at the UP-PGH. The initial psychiatric consultation notes and the discharge summary were reviewed for specific concordance of consultants recommendations for diagnostic action and use of psychotropic drugs with consultees implementing such recommendations and including the psychiatric diagnosis in the final diagnosis. The program EPI-INFO 6 was used in data analysis. Results: Among the 4 percent of cases with recommendations for diagnostic action, there was only 50 percent concordance with the consultees. Of the 56 percent of cases with recommendations for use of psychotropic drugs there was a 79 percent concordance with the consultees. Representations for psychiatric diagnosis in the discharge summary revealed concordance in 32 percent of the cases, partial concordance in 6 percent and non-concordance in 62 percent of the cases. Conclusion: Diagnostic work-ups and referrals to other clinical services were not usually included in the management plan of the psychiatrist. Only half of the consultees followed such recommendations. Despite the fact that most consultees requested for an evaluation, only a third gave a representation of the psychiatrists diagnosis in the discharge summary. Suggesting that the consultees were more able to place the psychiatric issue within the familiar context of the medical model, there was a relatively higher concordance for recommendations for psychotropic drugs. This work highlights the wide latitude for improvement for psychiatric consultations in the general hospital setting.
Human ; Male ; Female ; MENTAL DISORDERS ; PSYCHOTROPIC DRUGS ; REFERRAL AND CONSULTATION