Accuracy of psychiatric diagnoses in consultation liaison psychiatry

Abstract

Objective It is well known that the comorbidity between medical diseases and psychiatric disorders is high and affect medical care; the aim of this study is to asses to what extent physicians other than psychiatrist can accurately diagnose psychiatric disorders and give attention to psychological factors that may negatively affect medical disease course and prognosis Methods This is a prospective study where 157 referrals from different medical and surgical specialties were recruited and accuracy of psychiatric diagnoses were measured by comparing the initial impression or reason of referral given by referring physician to the final diagnosis confirmed by consulted psychiatrist Results In 74 patients (4714%) the initial impressions made by the referring physician were in accordance with the final diagnoses made by consultation liaison teams However in 83 patients (5286%) the initial impression by the referring physician was inaccurate as confirmed by the consultation liaison team Conclusions There is a low accuracy in diagnosing psychiatric illness in medically ill inpatients The most common psychiatric disorders in medically ill inpatients are depressive disorders with an accurate diagnosis in almost half of the patients Diagnoses of cognitive disorders or substance abuse by physicians other than psychiatrists are 100% accurate but misdiagnosis of cognitive disorders is common and they are easily mistaking them for other psychiatric diagnoses such as depression