Factors Predictive of Psychiatric Consultation-Liaison Practice in the Gynecology Clinic of a Nigerian Teaching Hospital

Abstract

There is a high rate of psychological distress among women attending gynecology clinics. Psychiatric morbidity among this group of patients has been studied but no clear-cut delineations in the association between psychiatric morbidity, established gynecological diagnosis and ongoing gynecological symptoms especially as guidelines for consultation-liaison practice in the gynecological unit. The objectives of this study therefore were to determine the prevalence of psychiatric disorders in this group of patients; to determine the association of psychiatric morbidity with ongoing gynecological complaints, gynecological diagnosis and psychosocial factors; and to delineate factors predictive of psychiatric consultation-liaison need in the gynecological clinic. Using structural questionnaires and employing a 2-stage screening methodology for patients attending the gynecological clinic of Ladoke Akintola University of Technology Teaching Hospital for about 12 weeks consecutively, a total of seventy eight patients were recruited invariably. The mean age of the study population was 35.9 years. Overall prevalence of psychiatric disorder was 55.3%. Depressive illness occurred in about 42.8% of the study population. No significant association between psychiatric morbidity, ongoing gynecological symptoms and established gynecological diagnosis. The commonest diagnosis was infertility. However, specific ongoing gynaecological complaints with psychiatric morbidity had 49.7% of those with inability to conceive (primary), 57.1% of those who had pains during intercourse, 71.4% of those with cessation of menses and 60% of those with irregular menses as opposed to lower scores among those with established gynecological diagnosis. Specific on-going gynecological complaints may impose graver consequences on the psychological wellbeing of a woman than established gynecological diagnosis. The consideration and management of ongoing gynecological complaints and social support may be issues for psychiatric consultation-liaison crucial in the management of such patients to reduce psychiatric morbidity amongst them.