Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T18:35:04.107Z Has data issue: false hasContentIssue false
  • English
  • Français

Implication of rates of referral to a specialised inpatient neuropsychiatry team

Published online by Cambridge University Press:  13 June 2014

Finian M O'Brien ,
Pauline Devitt ,
Ciaran D Corcoran  and
Kieran C Murphy
Finian M O'Brien*
Affiliation:
Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
Pauline Devitt
Affiliation:
Beaumont Hospital, Beaumont Road, Dublin 9, Ireland Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
Ciaran D Corcoran
Affiliation:
Beaumont Hospital, Beaumont Road, Dublin 9, Ireland Beaumont Hospital, Beaumont Road, Dublin 9, Ireland
Kieran C Murphy
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland
*
*Correspondence E-mail: finobrien@rcsi.ie
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: This study examined and compared the number and pattern of referrals from neurosurgery and neurology specialist services to the inpatient liaison neuropsychiatry service in the years 2002 and 2005. We estimated the prevalence of psychiatric illness and evaluated the results of subsequent psychiatric assessment and follow-up of all patients reviewed by the neuropsychiatry service.

Methods: The medical notes of those patients referred to the neuropsychiatry team were retrospectively examined to obtain appropriate information on assessment and management of these cases.

Results: There were 544 referrals over the two years selected for study. Rates of referral to the inpatient neuropsychiatry service increased overall by 35% between 2002 and 2005. Overall, referrals from neurology comprised 85%, neurosurgery 15%. Patients with epilepsy comprised the majority of referrals (36%). A total of 378 (73%) had an acute psychiatric disorder and this group had a significantly higher rate (p = 0.01) of past psychiatric disorder (40%) than that in those with no acute mental illness (33%). Depressive episode was the most frequent acute psychiatric diagnosis (38%), followed by anxiety and organic psychiatric disorder (both 15%). Overall, 21% of patients diagnosed with acute mental illness were referred on discharge to the neuropsychiatry outpatient clinic for specialist follow up and the remainder followed-up by either local mental health teams or their GP.

Conclusions: These findings provide clear evidence that further resources should be allocated to expanding neuropsychiatry mental health services to improve detection and management of mental illness in this vulnerable patient group.

Keywords

Mental health servicesReferral and consultationHospitalsgeneralMental disordersEpidemiology
Type
Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 26 , Issue 4 , December 2009 , pp. 187 - 190
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Fleminger, S, Leigh, E, McCarthy, C. The size of demand for specialized neuropsychiatry services: rates of referrals to neuropsychiatry services in the South Thames Region of the United Kingdom. Jo Neuropsych Clin Neurosci 2006; 18: 121–128.CrossRefGoogle ScholarPubMed
2.Agrawal, N, Fleminger, S, Ring, H, Deb, S. Neuropsychiatry in the UK: planning the service provision for the 21st century. Psych Bull 2008; 32: 303–306.CrossRefGoogle Scholar
3.Beaumont Hospital Report 2004. Health Service Executive.Google Scholar
4.Pallant, J. SPSS survival manual: A step by step guide to data analysis using SPSS for Windows Version 11. Buckingham: Maidenhead, UK: Open University Press, 2001.Google Scholar
5.Government of Ireland: The Expert Group on Mental Health Policy: A Vision for Change. Dublin: Stationery Office, Dublin, 2006.Google Scholar
6.Jefferies, K, Owino, A, Rickards, H, Agrawal, N. Psychiatric disorders in neurology inpatients: estimate of prevalence and usefulness of screening questionnaires. J Neurosurg Psych 2006; Oct. 20th (published online: jnnp.bmj.com)CrossRefGoogle ScholarPubMed
7.Fink, P, Hansen, M, Sondergaard, L, Frydenburg, M. Mental illness in new neurological patients. J Neurol Neurosurg Psych 2003; 74: 817–819.CrossRefGoogle ScholarPubMed
8.Jonge, P, Huyse, FJ, Herzog, Tet al.Referral pattern of neurological patients to psychiatric consultation liaison services in 33 European hospitals. Gen Hosp Psych 2001; 23(3): 152–7.CrossRefGoogle ScholarPubMed
9.Lipsitt, DR. Psychiatry and the general hospital in an age of uncertainty. World Psych 2003; 2(2): 87–92.Google Scholar
10.Goggins, R, Pattison, F, Upton, M, Bird, JM. Detecting psychiatric comorbidity in patients with epilepsy or non epileptic attack disorder at a specialist neuropsychiatry tertiary referral centre: a clinical audit. Psychiatry On-Line. 2003. www.priory.com/psych/morbaudit.htmGoogle Scholar
11.Ballard, C, Powell, I, James, Iet al.Can psychiatric liaison reduce neuroleptic use and reduce health service utilization for dementia patients residing in care facilities. Int J Geriat Psych 2002; 17(2): 140–145.CrossRefGoogle ScholarPubMed
12.Barrett, K, Sudharsan, S. Service innovations: is there a market for neuropsychiatry? A year in the life of a district-based neuropsychiatry service. Psych Bull 2005; 29: 465–467CrossRefGoogle Scholar
13.Leonard, F, Majid, S, Sivakumar, Ket al.Service innovations: a neuropsychiatry outreach clinic. Psych Bull 2002; 26: 99–101.CrossRefGoogle Scholar
14.Department of Health: The National Service Framework for Mental Health: Modern standards and service models. London: Department of Health, 1999.Google Scholar