Referral to a Liaison Psychiatrist from a palliative care unit

Abstract

All referrals to a psychiatrist from a palliative care unit, during a one year period, were reviewed. The reasons for referral of patients from the unit, the psychiatric diagnosis on assessment, the intervention by the psychiatrist and the results of the intervention are discussed. Depressive illness was the commonest diagnosis in the 26 patients referred (50%). Sudden immobility due to a hemiplegia or paraplegia was noted to be a risk factor for the development of depression (17%). Family factors played a role in the presentation of 14 patients. In the majority of cases intervention by the psychiatrist was in the form of a diagnostic consultation, which led to guidelines for further management by the palliative care team. In four of the cases, intervention by the psychiatrist was more prolonged (greater than three interviews). Forty per cent of the patients referred showed an improvement in their mental state. The conclusion of the paper is that psychiatric assessment can be useful to the palliative care team, in the assessment and management of psychological disorder in patients with a terminal illness.