Consultation-liaison psychiatry in China

Ji, Jianlin; Ye, Chenyu

According to Lipowski, [1] the article published by George Henry in the American Journal of Psychiatry in 1929 marked the launch of consultation-liaison psychiatry (CLP) as a scientific discipline. Initially, the CLP doctor was scoffed at as 'a pleasant, pipe-smoking gentleman wearing a tweed jacket who, with much time on his hands, proselytized for the psychosocial model'. [2] Such stereotypes have changed over time. Today, CLP physicians are expected to have the multidisciplinary knowledge and skills needed to carry out psychiatric interviews; to conduct risk assessments and manage threats of suicide, assault, and agitation in common clinical settings; to interpret laboratory results; and to consider the physical, legal, and ethical issues when managing the psychiatric problems of patients with concurrent physical illnesses. They are also required to possess good communication skills when interacting with non-psychiatrists, other health care professionals, and patients' family members. [2] The specialty of CLP was initially launched in the United States and subsequently adopted worldwide, but its development in China has not been a smooth one. Prior to the founding of the People's Republic of China in 1949, psychiatric units had been established in some general hospitals in China, but there are no reports of CLP-type services. After 1949, the departments of psychiatry and clinical psychology established in many general hospitals started to provide CLP services, particularly in university teaching hospitals. In parallel with the rapid economic and social reforms that started in China in the 1980s, the concept of CLP has become more widely accepted by medical professionals and administrators; this has facilitated increased cooperation between departments of psychiatry and other clinical departments. This article briefly introduces the development of CLP in China and its current status.