Pattern and Prevalence of Psychiatric Consultations in Other Non-Psychiatric In-patient Facilities in the University of Port Harcourt Teaching Hospital( UPTH): A 5-year Review

Abstract

Background The tendency of other medical conditions to comorbid or present with psychiatric complications is on the increase. Several studies have put the prevalence of psychiatric co-morbidity with medical conditions at about 10- 20%, with an unmatched diagnostic ability by most clinicians. This has resulted in poor management and unfavorable outcomes. The aim of this study was to determine the pattern and prevalence of psychiatric comorbidity with other medical conditions in other non-psychiatric wards in UPTH.

Methods Approval for the study was obtained from the ethical committee of the hospital. A record was kept of all the consultations to psychiatry from every other unit in the hospital over 5 years. Both the psychiatric and non-psychiatric diagnoses made were all noted. Cases selected included any clinical conditions with comorbid psychiatric disorders while patients with only psychiatric diagnosis seen especially in the Accident and Emergency Department were all excluded from the study. The cases were reviewed by consultant neuropsychiatrists and psychiatric diagnoses were made using the DSM-IV TR diagnostic criteria. The total admissions in each unit of the hospital over the period under review were also determined.

Results The study showed that out of a total admission of 54, 7 45 in the entire clinical department within the period, 3217 consultations (representing 5.9%) were made to psychiatry. Out ofthis figure, 2778 cases of psychiatric comorbidities were diagnosed, (representing 86.4% of total consultations). This  shows a prevalence of psychiatric comorbidity (consultations) of 5.1%. (p=0.0001, Chi value= 3330.10). Internal Medicine was the highest, 604(22%) followed by Surgery with 496 (17%), Accident and  Emergency, 320 (12%), Obstetrics and Gynaecology 280(1 0%), Orthopaedic 267(9%), Burns and  Plastics 266(9%), Paediatrics 244 (9%), Ophthalmology 147(5.3%), ENT 102(4%) and ICU the least with 27(1%). The observed differences in psychiatric consultations among the department were statistically significant (p=0.001).

Conclusion The prevalence of psychiatric comorbidity is 5.1% in UPTH. There is need for sensitization  among clinicians to increase their clinical acumen to enable them recognizes cases requiring psychiatric attention, in addition to increasing their willingness to make necessary and timely consultations and I or referrals.

Keywords Pattern; Prevalence; Psychiatric consultations; UPTH.