Pattern of Psychiatric Referral in a Tertiary Care Hospital in Bangladesh

Introduction: Consultation-liaison Psychiatry (CLP) is the study, practice and teaching of the relation between medical and psychiatric disorders. Aim of the study: The aim of this study is to find out the referring department, reason for consultation, common psychiatric comorbidities and sociodemographic of the referred patients to psychiatry department from the other departments of Bangabandhu Sheikh Mujib Medical University of Dhaka. Methodology: This cross-sectional study was carried out from May 2018 to February 2020. Patients referred from different inpatient departments every Thursday were taken as study population. Psychiatric diagnoses of the patients were assigned by the consultant psychiatrist as per DSM-5 criteria. Semi structured questionnaire was used to collect socio-demographic data. Results: Among the referred patients (n= 89) 56% were female; 63% were aged between 19-59 years; 65% were married; 58% were from urban background and 51% studied up to higher secondary. More than half of the patients were referred from different branches of Medicine (68%). Referral from Internal Medicine was 14.6%, Rheumatology 13.5%, Neurology and Nephrology 10% respectively. The rest were from the branches of pediatrics, surgery and gynecology. Most common psychiatric disorder was Major Depressive Disorder (37%) followed by Obsessive-Compulsive Disorder (17%) and Delirium (10.11%). 15% patient received no psychiatric diagnosis. Conclusion: Psychiatric comorbidities in general medical illness are very common. CLP provides an opportunity to improve health outcomes for inpatients and reduce burden on the healthcare system. Received: 11 May 2020 Accepted: 12 June 2020 DOI: https://doi.org/10.3329/bjm.v31i2. 48536 1. Associate Professor, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University; 2. Resident, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University; 3. Resident, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University; Address of Correspondence: Dr. Sultana Algin, Associate Professor, Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University; Mobile: 01552314981; email: algin28@gmail.com Introduction: Consultation-liaison Psychiatry (CLP) is the study, practice and teaching of the relation between medical and psychiatric disorders.1 CLP provides a huge scope for bridging the gap between medicine and psychiatry. Physical and psychiatric disorders often co-occur which complicates the course and prognosis of each disorder. Psychiatric consultation in general medical setting reduces the treatment cost, mortality, morbidity and treatment related stigma.2 Before establishment of psychiatric units in general medical hospital, psychiatric services were based on psychiatric hospitals only. The incorporation of psychiatric unit in general medical hospitals creates the opportunity for easy access to psychiatric services. Bangladesh is a densely populated country with approximately 16 million people. Bangabandhu Sheikh Mujib Medical University (BSMMU) has been serving as one of the leading tertiary centers for people around the country since 1965. BSMMU has been recognized as the center of excellence. The Department of Psychiatry of the university starts operating from 1975. Since inception, the department has been offering indoor, outdoor and referral services. The prevalence of psychiatr ic disorder in Bangladesh is 16.8%. Among them Depressive disorders (6.7%), Anxiety disorders (4.5%) and Somatic symptom and related Disorders (2.1%) are high in frequency. But the treatment gap is 92.3% and most of the patients are treated by general physicians.3 Keeping in mind the scenario, it can Bangladesh J Medicine 2020; 31 : 76-80