Consultation-Liaison psychiatric service delivery: results from a European study.

The reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health, and mental health care.

European consultation-liaison services and their user populations: the European Consultation-Liaison Workgroup Collaborative Study.

The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in 11 European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred. The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology -- ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis -- ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.

European Consultation-Liaison Psychiatric Services: the ECLW Collaborative Study.

OBJECTIVE: To describe the patterns of organization of consultation-liaison (C-L) services in 11 European countries in relation to hospital characteristics and national approaches to C-L psychiatry. METHOD: Cross-sectional survey. RESULTS: Services can best be described in terms of their size and seniority of their staff and whether or not they are multidisciplinary. Single-discipline services are based upon the standard medical consultant model, whereas those with multidisciplinary teams work in a way that is comparable with community mental health teams. German psychosomatic C-L services belonged to either model. National differences were found. CONCLUSION: This first international study provides empirical evidence for the wide variation in the organization of C-L services. In view of the increasing numbers of patients with psychiatric disorder who are being treated in general hospitals and the changing patterns of medical care there are important implications for clarification and improvement of the role of C-L services.