Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study
Introduction: The referral of inpatients to psychiatry team is more in India due to the increase in the morbidity rates of people. The referrals to Psychiatric Department with a specific psychiatric diagnosis are considerably very low. Most often, the diagnosis made by the clinicians does not match...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2022-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/16809/55526_CE(AD)_F[SK]_PF1(SG_SHU)_PFA(SG_KM)_PN(KM).pdf |
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| author | Iniyan Selvamani Aswin Sasidharan B Haritha Sree B Minu Rekha Sumedha Dondapati |
| author_facet | Iniyan Selvamani Aswin Sasidharan B Haritha Sree B Minu Rekha Sumedha Dondapati |
| author_sort | Iniyan Selvamani |
| collection | DOAJ |
| description | Introduction: The referral of inpatients to psychiatry team is more in India due to the increase in the morbidity rates of people. The referrals to Psychiatric Department with a specific psychiatric diagnosis are considerably very low. Most often, the diagnosis made by the clinicians does not match with that of the psychiatrist. Physical illness is shown to have a strong association with psychiatric co-morbidity. Such association complicates the course and outcome of both the conditions.
Aim: To evaluate the pattern of inpatient referral to the Psychiatric Department and to estimate the diagnostic concordance between the referral and psychiatric team.
Materials and Methods: This retrospective study, with prior permission from the Department of Psychiatry, included all the inpatient referrals (n=310) to Psychiatry Department by other departments from January 2019 to December 2019. Data collection was done from March 2020 to August 2020 and data analysis from September 2020 to November 2020, in Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India. Data was obtained from a psychiatry referral register and was statistically analysed using Microsoft Excel (MS Office 2013) for percentage, mean and Standard Deviation (SD) for descriptive variables. Diagnostic concordance to assess the reason for referral and diagnostic accuracy in terms of reason of referral and psychiatric diagnosis was analysed using kappa statistics.
Results: The most common psychiatric disorder for referral was alcohol dependence syndrome 102 (32.9%) followed by depression 38 (12.3%) and adjustment disorders 34 (10.9%). Concordance was good for intellectual disorder (κ=1.00), depression (κ=0.969) and alcohol dependence syndrome (κ=0.963). Very low concordance was observed in diagnosing acute confusional state (κ=0.195) and panic disorder (κ=0).
Conclusion: Alcohol withdrawal syndrome, adjustment disorder and depression were the most common reasons in referring inpatients to psychiatry. Lower concordance for psychiatric disorders like acute confusional state and panic disorder could be explained by inadequate psychiatry exposure and hence be improved by better undergraduate psychiatry training. |
| first_indexed | 2024-04-10T09:11:43Z |
| format | Article |
| id | doaj.art-0c2c69e9a6054189af35c68140fbf1b4 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-04-10T09:11:43Z |
| publishDate | 2022-08-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-0c2c69e9a6054189af35c68140fbf1b42023-02-21T04:59:59ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-08-01168VC06VC0910.7860/JCDR/2022/55526.16809Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective StudyIniyan Selvamani0Aswin Sasidharan1B Haritha Sree2B Minu Rekha3Sumedha Dondapati4Associate Professor, Department of Psychiatry, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.Postgraduate Resident, Department of Psychiatry, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.MBBS Undergraduate, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.Assistant Professor, Department of Anatomy, Government Vellore Medical College, Vellore, Tamil Nadu, India.Postgraduate Resident, Department of Psychiatry, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India.Introduction: The referral of inpatients to psychiatry team is more in India due to the increase in the morbidity rates of people. The referrals to Psychiatric Department with a specific psychiatric diagnosis are considerably very low. Most often, the diagnosis made by the clinicians does not match with that of the psychiatrist. Physical illness is shown to have a strong association with psychiatric co-morbidity. Such association complicates the course and outcome of both the conditions. Aim: To evaluate the pattern of inpatient referral to the Psychiatric Department and to estimate the diagnostic concordance between the referral and psychiatric team. Materials and Methods: This retrospective study, with prior permission from the Department of Psychiatry, included all the inpatient referrals (n=310) to Psychiatry Department by other departments from January 2019 to December 2019. Data collection was done from March 2020 to August 2020 and data analysis from September 2020 to November 2020, in Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India. Data was obtained from a psychiatry referral register and was statistically analysed using Microsoft Excel (MS Office 2013) for percentage, mean and Standard Deviation (SD) for descriptive variables. Diagnostic concordance to assess the reason for referral and diagnostic accuracy in terms of reason of referral and psychiatric diagnosis was analysed using kappa statistics. Results: The most common psychiatric disorder for referral was alcohol dependence syndrome 102 (32.9%) followed by depression 38 (12.3%) and adjustment disorders 34 (10.9%). Concordance was good for intellectual disorder (κ=1.00), depression (κ=0.969) and alcohol dependence syndrome (κ=0.963). Very low concordance was observed in diagnosing acute confusional state (κ=0.195) and panic disorder (κ=0). Conclusion: Alcohol withdrawal syndrome, adjustment disorder and depression were the most common reasons in referring inpatients to psychiatry. Lower concordance for psychiatric disorders like acute confusional state and panic disorder could be explained by inadequate psychiatry exposure and hence be improved by better undergraduate psychiatry training.https://jcdr.net/articles/PDF/16809/55526_CE(AD)_F[SK]_PF1(SG_SHU)_PFA(SG_KM)_PN(KM).pdfalcoholdeliriumdepressionkappa |
| spellingShingle | Iniyan Selvamani Aswin Sasidharan B Haritha Sree B Minu Rekha Sumedha Dondapati Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study Journal of Clinical and Diagnostic Research alcohol delirium depression kappa |
| title | Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study |
| title_full | Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study |
| title_fullStr | Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study |
| title_full_unstemmed | Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study |
| title_short | Referral Pattern of Inpatients to Psychiatry Department and the Diagnostic Concordance between the Referral Departments and Psychiatry Team- A Retrospective Study |
| title_sort | referral pattern of inpatients to psychiatry department and the diagnostic concordance between the referral departments and psychiatry team a retrospective study |
| topic | alcohol delirium depression kappa |
| url | https://jcdr.net/articles/PDF/16809/55526_CE(AD)_F[SK]_PF1(SG_SHU)_PFA(SG_KM)_PN(KM).pdf |
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