Consultation-liaison psychiatry in China

Ji, Jianlin; Ye, Chenyu

The study designs varied. Only one of the studies was prospective; [20] all the others were retrospective. Most of the studies are descriptions of the proportions of referrals from different clinical departments and proportions of different diagnoses in the patients seen. Only 6 of the 20 studies provided consultation rates (ranging from 0.02 to 3.6%) and only 14 of the studies reported the diagnostic criteria that were used to make the diagnosis. Most consultation requests come from departments of neurology, possibly due to the historical relationship of the two departments in China (up until 1994 psychiatry in China was a sub-discipline of neurology). Organic mental disorder was the most frequent reason for consultation, accounting for 24 to 87% of all referrals. The findings varied by geographic region and by type of hospital. In the tertiary (highestlevel) hospitals in socioeconomically developed areas, the consultation rate was high and the proportion of referrals with organic mental disorder was relatively low (neurosis was a more common diagnosis in these settings); but in the less developed parts of the country consultation rates were low and the majority of referrals had an organic mental disorder or some other severe mental disorder. In recent years the study designs have improved and the range of issues addressed has expanded: more studies now include psychiatric follow-up of referred patients, [20] comparisons between emergency consultation and regular consultation, [28] and descriptions of the psychiatric consultation processes in specific medical departments. [27, 30]