Liaison psychiatric services

Liaison psychiatrists work with medical and surgical staff, and may have their own multidisciplinary teams of clinical psychologists, social workers, and specialized psychiatric nurses. Their role includes the following:

• Assessing and treating referred patients. A report by the Royal College of Physicians and the Royal College of Psychiatrists classified clinical problems into the following groups:

- organic disease with associated psychiatric disorder

- cerebral complications of organic disease

- bodily symptoms not due to organic disease (medically unexplained symptoms)

- abuse of alcohol and drugs

- deliberate self-harm (DSH)

- sexual or relationship problems; eating disorders.

• Educating general hospital staff about recognizing psychiatric disorder and the principles of its management.

• Implementing screening programmes for detection of psychiatric disorder; for example, asking all patients to complete the Hospital Anxiety and Depression (HAD) Scale and interviewing the high scorers.

• Research into relationships between medical and psychiatric illness.

• Staff support: helping to address work-related problems and stress.

Space does not permit individual medical conditions to be considered here. Many psychiatric studies have been carried out on disorders such as HIV/AIDS, cancer, cardiac disease, diabetes, epilepsy, Parkinson's disease, renal failure, skin diseases, and stroke. Each condition has some unique features but similar general principles apply to them all.

Reference

Gill, D. and Hatcher, S. (1999). A systematic review of the treatment of depression with antidepressant drugs in patients who also have a physical illness. J Psychosom Res 47, 131-143.

Further reading

The Psychological Care of Medical Patients (2003). Royal College of Physicians/Royal College of Psychiatrists.

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