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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
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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

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