Aisha Noorullah, Bilal Ahmed, Muhammad Yusuf Hafiz, Shahina Pirani, Murad Khan
{"title":"COVID-19患者转诊精神科会诊模式：巴基斯坦卡拉奇一家多学科医院的经验","authors":"Aisha Noorullah, Bilal Ahmed, Muhammad Yusuf Hafiz, Shahina Pirani, Murad Khan","doi":"10.29271/jcpsp.2025.01.111","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine referral patterns for psychiatric consultations among COVID-19 patients encompassing both the in-patient and Emergency Department of a multidisciplinary hospital in Karachi, Pakistan.</p><p><strong>Study design: </strong>A retrospective chart review. Place and Duration of the Study: The Aga Khan University Hospital, Karachi, Pakistan, from March 2020 to December 2021.</p><p><strong>Methodology: </strong>The research team collected pertinent information from medical records using a standardised proforma, which encompassed data from physicians' notes, nurses' notes, assessment forms, and discharge summaries. The data were analysed using descriptive and inferential statistics.</p><p><strong>Results: </strong>This study examined 233 psychiatric referrals, with 67% male patients (n = 156) and 57.1% (n = 133) aged above 60 years. The primary psychiatric diagnosis was delirium (47.1%, n = 105), followed by adjustment disorders (10.8%, n = 27) and mood disorders (11.7%, n = 25). The main symptoms leading to consultation were agitation/confusion (45%, n = 106) and psychotropic adjustment (18%, n = 41). Clinical outcomes, including mortality, were associated with agitation/confusion (p = 0.001), delirium (p = 0.001), older age (p = 0.003), and longer length of stay (p = 0.001). Patients aged 61 years and above exhibited frequent agitation/confusion (p = 0.002) and delirium (p = 0.001). Longer stays correlated with agitation/confusion (p = 0.022), and a one-month hospital stay showed an association with delirium (p = 0.050).</p><p><strong>Conclusion: </strong>This study highlights the crucial role of consultation-liaison psychiatric services in addressing the psychological issues in COVID-19 patients. The significance of delirium and its high mortality risk underscores the need for focused research and integration of mental health care into pandemic responses for comprehensive patient care.</p><p><strong>Key words: </strong>Referrals, Psychiatric consultations, Hospitalised patients, COVID-19, Pakistan, Consultation-liaison services.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"111-115"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pattern of Referral of Patients with COVID-19 for Psychiatric Consultation: Experience at a Multidisciplinary Hospital in Karachi, Pakistan.\",\"authors\":\"Aisha Noorullah, Bilal Ahmed, Muhammad Yusuf Hafiz, Shahina Pirani, Murad Khan\",\"doi\":\"10.29271/jcpsp.2025.01.111\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine referral patterns for psychiatric consultations among COVID-19 patients encompassing both the in-patient and Emergency Department of a multidisciplinary hospital in Karachi, Pakistan.</p><p><strong>Study design: </strong>A retrospective chart review. Place and Duration of the Study: The Aga Khan University Hospital, Karachi, Pakistan, from March 2020 to December 2021.</p><p><strong>Methodology: </strong>The research team collected pertinent information from medical records using a standardised proforma, which encompassed data from physicians' notes, nurses' notes, assessment forms, and discharge summaries. The data were analysed using descriptive and inferential statistics.</p><p><strong>Results: </strong>This study examined 233 psychiatric referrals, with 67% male patients (n = 156) and 57.1% (n = 133) aged above 60 years. The primary psychiatric diagnosis was delirium (47.1%, n = 105), followed by adjustment disorders (10.8%, n = 27) and mood disorders (11.7%, n = 25). The main symptoms leading to consultation were agitation/confusion (45%, n = 106) and psychotropic adjustment (18%, n = 41). Clinical outcomes, including mortality, were associated with agitation/confusion (p = 0.001), delirium (p = 0.001), older age (p = 0.003), and longer length of stay (p = 0.001). Patients aged 61 years and above exhibited frequent agitation/confusion (p = 0.002) and delirium (p = 0.001). Longer stays correlated with agitation/confusion (p = 0.022), and a one-month hospital stay showed an association with delirium (p = 0.050).</p><p><strong>Conclusion: </strong>This study highlights the crucial role of consultation-liaison psychiatric services in addressing the psychological issues in COVID-19 patients. The significance of delirium and its high mortality risk underscores the need for focused research and integration of mental health care into pandemic responses for comprehensive patient care.</p><p><strong>Key words: </strong>Referrals, Psychiatric consultations, Hospitalised patients, COVID-19, Pakistan, Consultation-liaison services.</p>\",\"PeriodicalId\":94116,\"journal\":{\"name\":\"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP\",\"volume\":\"35 1\",\"pages\":\"111-115\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.29271/jcpsp.2025.01.111\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.29271/jcpsp.2025.01.111","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Pattern of Referral of Patients with COVID-19 for Psychiatric Consultation: Experience at a Multidisciplinary Hospital in Karachi, Pakistan.
Objective: To determine referral patterns for psychiatric consultations among COVID-19 patients encompassing both the in-patient and Emergency Department of a multidisciplinary hospital in Karachi, Pakistan.
Study design: A retrospective chart review. Place and Duration of the Study: The Aga Khan University Hospital, Karachi, Pakistan, from March 2020 to December 2021.
Methodology: The research team collected pertinent information from medical records using a standardised proforma, which encompassed data from physicians' notes, nurses' notes, assessment forms, and discharge summaries. The data were analysed using descriptive and inferential statistics.
Results: This study examined 233 psychiatric referrals, with 67% male patients (n = 156) and 57.1% (n = 133) aged above 60 years. The primary psychiatric diagnosis was delirium (47.1%, n = 105), followed by adjustment disorders (10.8%, n = 27) and mood disorders (11.7%, n = 25). The main symptoms leading to consultation were agitation/confusion (45%, n = 106) and psychotropic adjustment (18%, n = 41). Clinical outcomes, including mortality, were associated with agitation/confusion (p = 0.001), delirium (p = 0.001), older age (p = 0.003), and longer length of stay (p = 0.001). Patients aged 61 years and above exhibited frequent agitation/confusion (p = 0.002) and delirium (p = 0.001). Longer stays correlated with agitation/confusion (p = 0.022), and a one-month hospital stay showed an association with delirium (p = 0.050).
Conclusion: This study highlights the crucial role of consultation-liaison psychiatric services in addressing the psychological issues in COVID-19 patients. The significance of delirium and its high mortality risk underscores the need for focused research and integration of mental health care into pandemic responses for comprehensive patient care.
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