[Indications for psychiatric consultation: a case-specific parallel survey of psychiatrists and treating physicians]

Abstract

In a prospective study about the consultation triad (doctor-doctor-patient) 334 of 388 consecutive psychiatric consultations at two large hospitals of Lübeck within 5 months have been analyzed. The psychiatric consultant and the doctor on duty answered questions with regard to diagnosis, treatment indication and after care. 162 physicians (22 psychiatric consultants and 140 physicians working in 14 different departments) took part in the study. On one hand it turned out that there were specific indications for different diagnosis groups. On the other hand the two samples of physicians presented surprising differences with regard to their (case related) treatment indications and after care options. Psychiatrists found it less important to carry out reconsultations and the somatic orientated doctors emphasized more often psychodynamical orientated interventions for patients in contrast to the psychiatrists. Psychiatrists in contrast have been more sensitive for atmospheric tensions at the ward. These differences even grew following the amount of practice. Gerontopsychiatric patients turned out to be a special problem group. Doctors of both groups rarely share their opinion with regard to after care options.