La psychiatrie de consultation-liaison: une étude prospective en milieu hospitalier général

Abstract

This study was conducted in Halifax, Nova Scotia, in a 740 bed university general hospital. For a period of two years, a prospective collection of data on 692 psychiatric consultations showed that 60% of all consultations came from internal medicine departments. Medical and psychiatric comorbidity was found in 50% of the patients; depression was diagnosed in 27.5% of the cases but schizophrenia in only 1.7%. Suicidal ideation was reported by 24% of the patients, 11.6% of them wishing to die imminently. More than 50% of suicidal patients were under 35 years of age; 42% of them were dependent on alcohol. Almost 30% of the patients seen in consultation admitted to being addicted to alcohol, 22% to benzodiazepines and 14% to illicit drugs. Among the ex-alcoholic patients, a significant dependence in benzodiazepine use was found. The patients with addictions to street drug had a greater suicide risk and were at the same time abusing alcohol. This paper will describe the overall functioning of a consultation-liaison psychiatric service and will analyze the impact of psycho-active substance abuse in a general hospital setting. The results will be compared with those in the literature.