The establishment and first six months of a psychiatric consultation-liaison service to an Australian obstetric and gynaecology hospital is described. Referrals, diagnoses and follow-up of patients are discussed, with case reports used to illustrate the types of patients seen. Evaluation of the findings and Dossible future directions for the service are discussed.
References
1.
ReigerDAMyersJKKramerHRobinsonNBlazerDGHoughRLEatonWWLockeBZ.The NIMH Epidemiologic Catchment Area (ECA) Program: historical context, major objectives and study population characteristics. Archives of General Psychiatry1984; 41:934–041.
2.
HendersonSDuncan-JonesPByrnePGScottRAdcockS.Psychiatric disorder in Canberra. Standardised study of prevalence. Acta Psychiatrica Scandinavica1979; 60: 355–374.
3.
WellsJEBushnellJAHornblowARJoyePROakley-BrowneMA.Christchurch Psychiatric Epidemiology Study, Part I: Methodology and lifetime prevalence for specific psychiatric disorder. Australian and New Zealand Journal of Psychiatry1989; 23:327–340.
4.
WaltonVRomans-ClarksonSDonsD.The Otago Women's Health Survey 1985–1990. Second report — November 1990. Department of Psychological Medicine, University of Otago, 1990.
5.
BallingerCBSmithAH.Factors associated with psychiatric morbidity in women — a general practice survey. Acta Psychiatrica Scandinavica1985; 71:272–279.
6.
RedmanSHennrikusDBowmanJSanson-FisherR.Assessing women's health needs. Medical Journal of Australia1988; 148:123–127.
7.
WorsleyAWaltersWWoodE.Screening for psychological disturbance amongst gynaecology patients. Australian and New Zealand Journal of Obstetrics and Gynaecology1977; 17:214–219.
8.
ByrneP.Psychiatric morbidity in a gynaecology clinic: an epidemiological survey. British Journal of Psychiatry1984; 144:28–34.
9.
BallingerCB.Psychiatric morbidity and the menopause. Survey of Gynaecology Outpatient Clinic. British Journal of Psychiatry1984; 144: 28–34.
10.
Women's Health Policy Review Committee.Women's Health Services in New South Wales. Sydney: NSW Government Printer1985 (NSW Parliamentary Paper number 403, 1984–1985).
11.
VewLNeedJ.Women's health needs. Medical Journal of Australia1988; 148:110–112.
12.
National Women's Health Policy 1989. Australian Government Publishing Service, Canberra.
13.
EsquirolE. In: Mental maladies: A treatise on insanity (translated by HuntEK). Philadelphia: Lea and Blanchard, 1845.
14.
PaffenbergerRS.Epidemiological aspects of parapartum mental illness. British Journal of Preventive and Social Medicine1964; 18:189–195.
15.
KendellRERennieDClarkeJAThe social and obstetric correlates of psychiatric admission in the puerperium. Psychological Medicine1981a; 11:341–350.
16.
KendellREMcGuireRJConnorY.Mood changes in the first 3 weeks after childbirth. Journal of Affective Disorders1981b; 3:317–326.
17.
KendellREWainwrightSHaileyAThe influence of childbirth on psychiatric morbidity. Psychological Medicine1976; 6:297–302.
18.
CutronaCE.Non-psychotic postpartum depression: A review of recent research. Clinical Psychology Review1982; 2:487–503.
19.
KumarRRobsonKM.A prospective study of emotional disorders in childbearing women. British Journal of Psychiatry1984; 144:35–47.
20.
TongeBJ.Postnatal mood states, mother/child interaction and child development 1984. Unpublished doctoral thesis, University of Melbourne.
21.
PittB.Atypical depression following childbirth. British Journal of Psychiatry, 1968; 114–1325.
22.
DennersteinLvan HallE.Hysterectomy. In: Psychosomatic gynaecology — a total approach to women's health. Lancaster: Parthenon, 1986; 119–137.
23.
DennersteinLWoodCBurrowsG.Hysterectomy. Melbourne: Oxford University Press, 1989:11.
24.
MartinRLRobertsWVClaytonPTWetzelR.Psychiatric illness and non-cancer hysterectomy. Disease of the Nervous System1977; 12:974–980.
25.
MartinRLRobertsWVClaytonDJ.Psychiatric status after hysterectomy. Journal of the American Medical Association1980; 244:350–353.
26.
RyanMDennersteinLPepperellR.Psychological aspects of hysterectomy — a prospective study. British Journal of Psychiatry1989; 54:516–522.
27.
GathDCooperPDayA.Hysterectomy and psychiatric disorders: levels of psychiatric morbidity before and after hysterectomy. British Journal of Psychiatry1982; 140:335–350.
28.
SteegeJ.Chronic pelvic pain: clinical perspectives. In: Handbook of psychosomatic obstetrics and gynaecology. DennersteinLBurrowsG, eds. Amsterdam: Elsevier, 1983:401.
29.
RollinsB.Sexual attitudes and behaviour — a review of the literature. Melbourne: Australian Institute of Family Studies, 1989.
30.
DanilukJLeaderATaylorR.The psychological sequelae of infertility. In: Progress in psychiatry: the psychiatric implications of menstruation. Washington DC: American Psychiatric Press1985; 75–86.
31.
CondonJT.Pathological grief reactions after stillbirth. American Journal of Psychiatry1986; 143:987–992.
32.
TheutSPedersenFZaslowMCainRRahinorchBMorihisaJ.Prenatal loss and bereavement. American Journal of Psychiatry1989; 146:635–639.
33.
KennellJSlykerHKlausM.The mourning response of parents to the death of a newborn infant. New Oxford Journal of Medicine1970; 273:344–349.
34.
FriedmanTGathD.The psychiatric consequences of spontaneous abortion. British Journal of Psychiatry1989; 153:810–813.
35.
PasnauRO, ed. Psychiatry and obstetrics-gynaecology. Report of 9 five-year experiences in psychiatry liaison. In: Consultation-liaison psychiatry. New York: Grune Stratton, 1975:135–147.
36.
MathisJ.Psychiatry and the obstetrician-gynaecologist. Medical Clinics of North America1967; 51:1375–1380.
37.
HertzD.Problems and challenges of consultation psychiatry in gynaecology and obstetrics. Psychotherapy and Psychosomatics1974; 23:67–77.
38.
RipleyD.Audit of obstetric liaison psychiatry in 1984. Journal of Reproductive and Infant Psychology1986; 4:99–115.
39.
KumarR.Postpartum psychoses. In: Ballieres Clinical obstetrics and gynaecology. Psychological Aspects of Obstetrics and Gynaecology1989; 3: 823–838.
40.
MearesRGrimwadeJWoodK.A possible relationship between anxiety in pregnancy and puerperal depression. Journal of Psychosomatic Research1976; 20:605–610.
41.
DaltonK.Prospective study into puerperal depression. British Journal of Psychiatry1971; 118:689–692.
42.
DennersteinLLehertPRiphagenF.Postpartum depression — risk factors. Journal of Psychosomatic Obstetrics and Gynaecology, 1989; 10: 53–67.
43.
ZajiceckEWolkindS.Emotional difficulties in married women during and after the first pregnancy. British Journal of Medical Psychology1978; 51:379–385.
44.
PaykelEEmmseEFletcherJRossabyE.Life events and social support in puerperal depression. British Journal of Psychiatry1980; 136:339–346.
45.
AppelbyLFoxHShawMKumarR.The psychiatrist in the obstetric unit — establishing a liaison service. British Journal of Psychiatry1989; 154–510–515.
46.
StrainJJHamermanD.Ombudsmen (medical psychiatric) rounds: an approach to meeting patient-staff needs. Annals of Internal Medicine1978; 33:550–553.
47.
LipowskiZJ.Consultation-liaison psychiatry: An overview. American Journal of Psychiatry1974; 131:623–630.
