Changes in patterns of psychiatric referral in a German general hospital: results of a comparison of two 1-year surveys 8 years apart

The aim of this study was to investigate the issues of changes in patterns of referral and interventions and of consistency of psychiatric diagnoses a ssigned by a psychiatric consultation-liaison service in a general hospital over an 8-year period. We compared two 1-year surveys 8 years apart. Surve y A comprised 713 referrals in 1990, and Survey B included 1025 consecutive new consultations in 1998. Data pertained to demographic characteristics, source of referral, reason for referral, psychiatric diagnosis according to DSM-III-R, and intervention. Our study demonstrated significant changes in diagnostic characteristics and in patterns of referral and intervention ov er the years. Changes in source of referral and psychiatric diagnoses were associated with the increasing involvement of clinical psychologists and sp ecialists in psychosomatic medicine. Also, surgeons and physicians were inc reasingly aware of psychiatric morbidity in medical-surgical populations. M odem psychopharmacological treatment approaches resulted in a higher rate o f recommendation of psychotropic medication. To ameliorate the provision of psychiatric care for general hospital patients, the need. for a biopsychos ocial conceptual framework at the interface of psychiatry and medicine in g eneral hospitals should be underscored. (C) 2001 Elsevier Science Inc. All rights reserved.