Pattern of Referrals to Psychiatrist in a Multi-specialty Tertiary Hospital in Nigeria: A Retrospective Study. Pattern of in-hospital referrals to psychiatrists

Abstract

Background: Consultation-liaison psychiatry (C-LP) plays a crucial role in integrating mental health care in tertiary care hospitals, yet the referral pattern to psychiatric services is inadequately documented in Nigeria. Methods: This cross-sectional retrospective study examined the referral patterns to the psychiatry department at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, over a two-year period (2022-2024). Data from 263 in-hospital referrals were analysed with SPSS version 23, focusing on referral departments, sub-specialties, reasons for psychiatric consultation, and psychiatric diagnoses. Results: The study indicated that Internal Medicine (46.8%) and Surgery (27.4%) were the predominant sources of referrals, with frequent requests originating from Neuro-surgery and Cardiology sub-specialties. The majority of referrals were prompted by confusion and irrelevant speech (50.1%) or disturbing behaviours such as restlessness and aggression (41.9%). Notably, 57.0% of referrals did not specify a psychiatric diagnosis. Schizophrenia/psychosis and major depression were the most commonly diagnosed conditions. Conclusion: Despite the benefits of C-L Psychiatry as reported in the literature, there was underutilization of psychiatric consultations, as evidenced by the relatively low referral rates from diverse specialties. This underscores a critical necessity for increased awareness and integration of psychiatric services throughout all medico-surgical departments.