The Impact of Screening Psychiatric Comorbidity and High-risk Feedback on Liaison Psychiatric Consultation Rates and Clinicians’ Attitudes on a Neurology Ward

Abstract

Introduction

Lifetime prevalence of psychiatric comorbidity in neurological patients is as high as 55%, but it remains often undetected and therefore untreated in hospital settings. Further, clinicians tend to make little use of the consultative and liaison psychiatric team for detection and treatment of anxiety and mood disorders in neurological patients. The current study aimed to investigate whether the implementation of a stepped screening protocol with high risk feedback to the clinician had an influence on the use of consultative and liaison psychiatric services.

Method

All patients admitted to the neurological ward were assessed using a stepped screening protocol for depression, anxiety and substance use during 15 months. Positive screening resulted in feedback to the clinicians depending on the study phase (e.g. feedback vs. no feedback).

Results

No differences were found in the use of consultative and liaison psychiatric services during the non-feedback and feedback phase.

Conclusion

Screening and high risk feedback of psychiatric comorbidity in neurological patients does not increase psychiatric referral rates. It points to the necessity of a more integrated collaborative care model for detection and treatment of psychiatric comorbidity.

Disclosure of interest

The authors have not supplied their declaration of competing interest.