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Fifth stage
Psychiatry
Lec-10
د. الهام الجماس
7/10/2015
Liaison Psychiatry
Liaison psychiatry
Covers all aspect of psychiatry relavent to general medicine it is concern with the
development of psychological factors in diagnosis , management and prevention of illness .
Many illness are now thought to have psychological aetiology and the role of psychological
factors becoming clearer in many conditions ( e.g. Coronary artery disease )
- Diagnostic differences are often solved by a thorough assessment of psychological
factors .
- Psychiatric methods and skills are useful both in the management of chronic
psychological and psychiatric illness in general medical setting .
- Prevention of illness often involves in change as in behaviour (e.g. Stop smoking , drinking
and taking exercise) an appreciation of psychological factors affecting these behaviour is
useful .
- Psychiatric training is not necessary for application of liaison psychiatry for example self –
poisoning used to be created as psychiatric case but it is increasingly accepted that many
of these have no psychiatric
The Role of general hospital staff
General hospital medical teams assess and treat many of psychological and social problems
under their care , although all the member of the team need to be able to manage these
problems psychiatrists and psychologist may provide training and supervision for medical
and other members of staff and care for the pts. Who require specialist treatment .
Consultation and Liaison Psychiatry
Psychiatric services for general hospital are widely referred to as consultation liaison
services .
In consultation work the psychiatrist is available to give opinion on pts. referred by
physician and surgeons .
In liaison work the psychiatrist is a member of medical or surgical team and offer advice
about the pt. care .
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The aim of liaison ( )هام
Is to increase the skills of other staff in assessment and management of psychological
problems .
Consultation and liaison units vary in their size and organization and others by a team of
psychiatrist nurses , social workers and clinical psychiatrists some liaison services have in
pts. Leda for pts. Who are both medically ill. and psychologically disturbe .
The role of liaison psychiatrist ()هام
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To make links with other disciplines .
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To identify psychiatric disorder.
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To assess its relevance to any existing organic disorder.
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To provide a management plan for the individual in consultation with the physicians
and surgeons .
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To communicate with all staff so that this plan can be executed تم او انجز
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Teaching
Common Reasons for referring to liaison psychiatrist
- No organic cause for the physical symptoms found .
- The symptoms continue despite treatment .
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Behavioural disturbance in the ward .
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Pt. Appear to be unable to manage at home .
Psychiatric Emergency in general hospital ( (غير مطلوب
The successful management of psychiatric emergency stress of the initial clinical interview
its aim as follow:-
1. To establish a good relationship with the pt.
2. To elicit information from pt. and other information.
3. To observes pt. behaviour and mental state .
If the pt. Is violent it is essential to arrange for help , physical contact should not be
attempted unless the pt. agree extrem caution is required .