Lahoud Touma1, Danny Diep1, Filza Hussain2, Shefali Dujari2
1Stanford Healthcare, 2Stanford University School of Medicine
Objective:
To identify the most common reasons for psychiatric consultations for patients admitted to the inpatient general neurology service, as well as final diagnoses and recommendations.
Background:
Patients admitted to neurology often suffer from comorbid psychiatric conditions. Historically branching from the same field, psychiatry and neurology share conditions affecting the same organ. Nevertheless, the two branches have become increasingly specialized, as reflected in their distinct scope of practice and training programs. Therefore, academic programs must be selective about what to teach about each specialty respectively.
Design/Methods:
All psychiatry consultations for patients admitted to the general neurology service at our institution were collected from 1/1/2022-10/12/2023. The chart review was performed using the STAnford Research Repository (STARR) tools. The protocol was approved by the Institutional Review Board from Stanford University (ID: 71292). Patients admitted to the epilepsy monitoring unit or stroke ward were excluded. Children were also excluded. Extracted data include demographics, reason for admission and consultation, diagnoses, and recommendations.
Results:
Our initial search identified 139 medical charts. After thorough chart review screening, 56 unique patients were included. The average age was 53.9 years with 48.2% of male. The most common reasons for consultation were agitation, anxiety, and psychosis. The most common diagnoses were delirium, anxiety disorders and adjustment disorder. The consultation recommendations ranged from adjustments of insomnia medications (ex: melatonin, ramelteon) to more complex antipsychotic management and involuntary psychiatric holds.
Conclusions:
With this data, we were able to summarize the main reasons for consulting psychiatry on the general neurology ward. In addition to identifying potential knowledge gaps, this information can be used to improve residency and fellowship curricula and ultimately patient care. We also hope to increase collaborations between our deeply related disciplines. Next steps include conducting the inverse study about neurology consultations in patients admitted to psychiatry.