Timing of psychiatric consultations: the impact of social vulnerability and level of psychiatric dysfunction

Psychosomatics. 2000 Nov-Dec;41(6):505-11. doi: 10.1176/appi.psy.41.6.505.


The authors examined the timing of patient referrals to a psychiatric consultation-liaison service in relation to the patient's social vulnerability and level of psychiatric dysfunction. One hundred consecutive patients were assessed with the INTERMED, a method to document biopsychosocial and health care-related aspects of disease. Although 30% of patients were referred within the first day of admission, 19% of requests for referrals were made after 2 weeks. Late referral was associated with high social vulnerability and early referral with severe psychiatric dysfunction. The authors illustrate the disadvantages of a psychiatric liaison model focusing on psychopathology alone and demonstrate the need for an integrated patient assessment in the general hospital, focusing on detecting frail elderly patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Hospitals, University
  • Humans
  • Length of Stay
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / psychology
  • Middle Aged
  • Patient Care Team*
  • Psychiatric Department, Hospital
  • Psychiatry*
  • Referral and Consultation*
  • Social Support*