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CONSULTATION-LIAISON PSYCHIATRY
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C-L Psychiatry or clinical liaison psychiatry

Jun 03, 2018

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Mary Joy Oros
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Page 1: C-L Psychiatry or clinical liaison psychiatry

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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 :-)