โ Scribed by Dr. David N. Anderson; Robin M. Philpott
No coin nor oath required. For personal study only.
An eight-year retrospective evaluation of referrals to a psychogeriatric consultation service demonstrated a highly significant linear increase of total referrals with a selective change of case mix that included more depressions and fewer cases of acute confusion or referrals with no psychiatric disorder. This did not occur with referrals from general practice, where case mix remained stable though total referrals also increased. It is suggested that this selective change relates to an educational influence of the specialist consultation service operating within the hospital and represents a desirable change of referral behaviour. The degree of psychiatric morbidity on general hospital wards far exceeds the capacity of a consultation service whose primary objective must be education to enable non-psychiatrists to detect and manage the majority of these disorders without recourse to specialist referral. Research that will further define the elements of the educational process that have greatest impact is needed and offers a new research direction for liaison psychiatry of old age.
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