RESUMEN
Treatment of obsessive-compulsive-bipolar comorbidity is relatively challenging. This case report presents the improvement of both obsessive-compulsive and mood symptoms in a female patient treated with risperidone plus valproate. Her obsessive compulsive and manic symptoms, as assessed respectively by using The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Young Mania Rating Scale (YMRS), improved continuously and were totally ameliorated within 2 weeks of the combination treatment. As assessed by the use of The Montgomery-Asberg Depression Rating Scale (MADRS), the treatment regimen also did not induce a depressed mood. Obsessivecompulsive-bipolar comorbidity may be a condition that responds well to risperidone plus valproate. Chiang Mai Med Bull 2005;44(1):43-47.
RESUMEN
Objective: The aim of this study was to evaluate common problems in consultation-liaison psychiatry, characteristics of consulted patients, and medical and psychiatric diagnoses of the patients in Maharaj Nakorn Chiang Mai Hospital. Methods: We performed a retrospective descriptive study from June 2005 to August 2006. All participants were medically ill inpatients who consulted for psychiatric problems. The authors reviewed the demographic data such as age, sex, ward, systemic disease, medical disease, psychiatric provisional diagnosis and psychiatric diagnosis. Results: Four hundreds patients were consulted for psychiatric evaluation, 0.82 % of all general hospital inpatients, 235 (58.8 %) males and 165 (41.2 %) females. The modal age group was between 20 - 49 years old (58.8 %) mostly referred by the department of internal medicine and surgery. At discharge, common diagnoses were adjustment disorder (35.0 %), delirium (32.5 %), substance-related disorders (17.0 %), depressive disorders (13.3 %), and psychotic disorders (4.3 %). Sensitivity rates for diagnosis of these psychiatric disorders were 12.1%, 50.8%, 75 %, 43.4% and 64.7% respectively. Conclusion: Patients with high suicidal risk, in particular adjustment and depressive disorders are common in consultation-liaison psychiatry. Attention should also be given to patients with high risks of aggression, disruption, or disorganization, such as delirium, substance abuse, and psychotic disorders.