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Consultation-liaison psychiatry: How far have we come?

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Abstract

This article takes stock of how far the field of consultation-liaison psychiatry has come since its inception in the 20th century. In order to do this, we review its past in terms of its knowledge base in psychosomatic medicine and in terms of its practice at the bedside in the general hospital setting. We also offer a contemporary account of the field and finish with a subjective view of the opportunities and pitfalls faced during the next phase of consultation-liaison psychiatry in the 21st century.

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References and Recommended Reading

  1. Rogers MP, Fricchione G, Reich P: Psychosomatic medicine and consultation-liaison psychiatry. In The Harvard Guide to Psychiatry. Edited by Nicholi AM, Jr. Cambridge, MA: Belknap Press; 1999:362–389.

    Google Scholar 

  2. Lipowski ZJ: Review of consultation psychiatry and psychosomatic medicine. I. General principles. Psychosom Med 1967, 29:153–171.

    PubMed  CAS  Google Scholar 

  3. Lipowski ZJ, Wise TN: History of consultation-liaison psychiatry. In Textbook of Consultation Liaison Psychiatry. Edited by Wise MG, Rundell JR. Washington, DC: American Psychiatric Publishing; 2002:3–11.

    Google Scholar 

  4. Friedman RS, Molay F: A history of psychiatric consultation in America. Psychiatr Clin North Am 1994, 17:667–681.

    PubMed  CAS  Google Scholar 

  5. Schwab JJ: Consultation-liaison psychiatry: a historical overview. Psychosomatics 1989, 30:245–254.

    PubMed  CAS  Google Scholar 

  6. Henry GW: Some modern aspects of psychiatry in general hospital practice. Am J Psychiatry 1929, 86:481–499.

    Google Scholar 

  7. Neill JR: Once more into the breach: doubts about liaison psychiatry. Gen Hosp Psychiatry 1983, 5:205–208.

    Article  PubMed  CAS  Google Scholar 

  8. Lipowski ZJ: Consultation-liaison psychiatry—past failures and new opportunities. Gen Hosp Psychiatry 1979, 1:3–10.

    Article  PubMed  CAS  Google Scholar 

  9. Lipowski ZJ: Liaison psychiatry, liaison nursing, and behavioral medicine. Compr Psychiatry 1981, 22:554–561.

    Article  PubMed  CAS  Google Scholar 

  10. Strain JJ: Liaison psychiatry and its dilemmas. Gen Hosp Psychiatry 1983, 5:209–212.

    Article  PubMed  CAS  Google Scholar 

  11. Greenhill, MH: The development of liaison programs. In Psychiatric Medicine. Edited by Usdin G. New York: Brunner/ Mazel; 1977:115–191.

    Google Scholar 

  12. Borus JF, Barsky AJ, Carbone LA, et al.: Consultationliaison cost offset: searching for the wrong grail. Psychosomatics 2000, 41:285–288.

    Article  PubMed  CAS  Google Scholar 

  13. Grace SL, Abbey SE, Kapral MK, et al.: Effect of depression on five-year mortality after an acute coronary syndrome. Am J Cardiol 2005, 96:1179–1185.

    Article  PubMed  Google Scholar 

  14. Rumsfeld JS, Jones PG, Whooley MA, et al.: Depression predicts mortality and hospitalization in patients with myocardial infarction complicated by heart failure. Am Heart J 2005, 150:961–967.

    Article  PubMed  Google Scholar 

  15. Serebruany VL, Glassman AH, Malinin AI, et al.; Sertraline AntiDepressant Heart Attack Randomized Trial Study Group: Platelet/endothelial biomarkers in depressed patients treated with the selective serotonin reuptake inhibitor sertraline after acute coronary events: the Sertraline AntiDepressant Heart Attack Randomized Trial (SADHART) Platelet Substudy. Circulation 2003, 108:939–944.

    Article  PubMed  CAS  Google Scholar 

  16. Chrapko WE, Jurasz P, Radomski MW, et al.: Decreased platelet nitric oxide synthase activity and plasma nitric oxide metabolites in major depressive disorder. Biol Psychiatry 2004, 56:129–134.

    Article  PubMed  CAS  Google Scholar 

  17. Shapiro PA, Lesperance F, Frasure-Smith N, et al.: An open-label preliminary trial of sertraline for treatment of major depression after acute myocardial infarction (the SADHART Trial). Sertraline Anti-Depressant Heart Attack Trial. Am Heart J 1999, 137:1100–1106. Landmark study addressing the importance of recognizing and treating post-myocardial infarction depression with a serotoninspecific reuptake inhibitor.

    Article  PubMed  CAS  Google Scholar 

  18. ENRICHD investigators: Enhancing Recovery in Coronary Heart Disease (ENRICHD) study intervention: rationale and design. Psychosom Med 2001, 63:747–755.

    Google Scholar 

  19. van den Brink RH, van Melle JP, Honig A, et al.: Treatment of depression after myocardial infarction and the effects on cardiac prognosis and quality of life: rationale and outline of the Myocardial Infarction and Depression-Intervention Trial (MIND-IT). Am Heart J 2002, 144:219–225. First study to directly examine the effect of treatment of post-myocardial infarction depression on cardiac prognosis.

    Article  PubMed  Google Scholar 

  20. Williams JW, Jr, Katon W, Lin EHB, et al. for the IMPACT investigators: The effectiveness of depression care management on diabetes-related outcomes in older patients. Ann Intern Med 2004, 140:1015–1024. Large, randomized controlled trial demonstrating the benefits of collaborative care with psychiatry in older patients with diabetes and depression with poor glycemic control.

    PubMed  Google Scholar 

  21. de Groot M, Anderson R, Freedland KE, et al.: Association of depression and diabetes complications: a meta-analysis. Psychosom Med 2001, 63:619–630.

    PubMed  Google Scholar 

  22. Lustman PJ, Griffith LS, Clouse RE, et al.: Effect of nortriptyline on depression and glycemic control on diabetes, results of a double-blind, placebo-controlled trial. Psychosom Med 1997, 59:241–250.

    PubMed  CAS  Google Scholar 

  23. Ludman EJ, Katon W, Russo J, et al.: Depression and diabetes symptom burden. Gen Hosp Psychiatry 2004, 26:430–436.

    Article  PubMed  Google Scholar 

  24. Ciechanowski PS, Katon WJ, Russo JE: Depression and diabetes: impact of depressive symptoms on adherence, function and costs. Arch Intern Med 2000, 160:3278–3285.

    Article  PubMed  CAS  Google Scholar 

  25. Carlson LE, Angen M, Cullum J, et al.: High levels of untreated distress and fatigue in cancer patients. Br J Cancer 2004, 90:2297–2304.

    PubMed  CAS  Google Scholar 

  26. Bultz BD, Carlson LE: Emotional distress: the sixth vital sign in cancer care. J Clin Oncol 2005, 23:6440–6441.

    Article  PubMed  Google Scholar 

  27. Ashbury FD, Findlay H, Reynolds B, et al.: A Canadian survey of cancer patients’ experiences: Are their needs being met? J Pain Symptom Manage 1998, 16:298–306.

    Article  PubMed  CAS  Google Scholar 

  28. Newell SA, Sanson-Fisher RW, Savolainen NJ: Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst 2002, 94:558–584.

    PubMed  Google Scholar 

  29. Spiegel D, Giese-Davis J: Depression and cancer: mechanisms and disease progression. Biol Psychiatry 2003, 54:269–282.

    Article  PubMed  Google Scholar 

  30. Akaho R, Sasaki T, Mori S, et al.: Psychological factors and survival after bone marrow transplantation in patients with leukemia. Psychiatry Clin Neurosci 2003, 57:91–96.

    Article  PubMed  Google Scholar 

  31. Smedslund G, Ringdal GI: Meta-analysis of the effects of psychosocial interventions on survival time in cancer patients. J Psychosom Res 2004, 57:123–131.

    Article  PubMed  Google Scholar 

  32. Hunkeler EM, Katon WJ, Tang L, et al.: Long-term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care. Br Med J 2006, 332:259–263.

    Article  Google Scholar 

  33. Kornfeld DS. Consultation-liaison psychiatry: contributions to medical practice. Am J Psychiatry 2002, 159:1964–1972. An elegant summary of the major contributions of CL psychiatry to medical care in general hospitals.

    Article  PubMed  Google Scholar 

  34. DeFrances CJ, Hall MJ, Podgornik MN: National Hospital Discharge Survey. Advance data from Vital and Health Statistics 2003, no. 359. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2005.

  35. Hohmann AA, Larson DB, Thompson JW, et al.: Psychotropic medication prescription in U.S. ambulatory medical care. DICP 1991, 25:85–99.

    PubMed  CAS  Google Scholar 

  36. Pincus HA, Tanielian TL, Marcus SC, et al.: Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA 1998, 279:526–531.

    Article  PubMed  CAS  Google Scholar 

  37. Hyler SE, Gangure DP, Batchelder ST: Can telepsychiatry replace in-person psychiatric assessments? A review and meta-analysis of comparison studies. CNS Spectr 2005, 10:403–413.

    PubMed  Google Scholar 

  38. Manfredi L, Shupe J, Batki SL: Rural jail telepsychiatry: a pilot feasibility study. Telemed J E Health 2005, 11:574–577.

    Article  PubMed  Google Scholar 

  39. Thomas CR, Miller G, Hartshorn JC, et al.: Telepsychiatry program for rural victims of domestic violence. Telemed J E Health 2005, 11:567–573.

    Article  PubMed  Google Scholar 

  40. Frueh BC, Henderson S, Myrick H: Telehealth service delivery for persons with alcoholism. J Telemed Telecare 2005, 11:372–375.

    Article  PubMed  Google Scholar 

  41. Schachter, SC: Vagus nerve stimulation therapy summary: five years after FDA approval. Neurology 2002, 59(6 Suppl 4):S15-S20.

    PubMed  Google Scholar 

  42. Nahas Z, Marangell LB, Husain MM, et al.: Two-year outcome of vagus nerve stimulation (VNS) for treatment of major depressive episodes. J Clin Psychiatry 2005, 66:1097–1104.

    Article  PubMed  Google Scholar 

  43. Piper M, Abrams GM, Marks WJ, Jr: Deep brain stimulation for the treatment of Parkinson’s disease: overview and impact on gait and mobility. Neuro Rehabilitation 2005, 20:223–232.

    PubMed  Google Scholar 

  44. Tagliati M, Shils J, Sun C, et al.: Deep brain stimulation for dystonia. Expert Rev Med Devices 2004, 1:33–41.

    Article  PubMed  Google Scholar 

  45. Lefaucheur JP: Transcranial magnetic stimulation in the management of pain. Suppl Clin Neurophysiol 2004, 57:737–748.

    Article  PubMed  Google Scholar 

  46. Lisanby SH, Kinnunen LH, Crupain MJ: Applications of TMS to therapy in psychiatry. J Clin Neurophysiol 2002, 19:344–360.

    Article  PubMed  Google Scholar 

  47. Fricchione GL, Vlay SC: Neuropsychiatric aspects of arrhythmia evaluation and management. In Manual of Cardiac Arrhythmias: A Practical Guide to Clinical Management, Vol. 2. Edited by Vlay, SC. Boston: Little Brown; 1996:438–450.

    Google Scholar 

  48. American Association of Medical Colleges: AAMC Data Book: Statistical Information Related to Medical Education. Washington, DC: American Association of Medical Colleges; 2005.

    Google Scholar 

  49. American Psychiatric Association: Resident Census: Characteristics and Distribution of Psychiatry Residents in the U.S. 2004–2005. Arlington, VA: American Psychiatric Association, Office of Graduate and Undergraduate Education; 2005.

  50. Joseph RC, Fricchione GL, Bonds CL, et al.: Fellowship training in psychosomatic medicine—Where are we headed? Presentation at the 52nd Annual Meeting of the Academy of Psychosomatic Medicine. Santa Ana Pueblo, NM; November 16–20, 2005.

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Authors and Affiliations

  1. Massachusetts General Hospital, Warren 605, 55 Fruit Street, 02114, Boston, MA, USA

    Gregory Fricchione MD (Associate Chief of Psychiatry)

Authors
  1. Sherese Ali MD, FRCPC
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  2. Carrie Ernst MD
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  3. Manuel Pacheco MD
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  4. Gregory Fricchione MD
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Correspondence to Gregory Fricchione MD.

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Ali, S., Ernst, C., Pacheco, M. et al. Consultation-liaison psychiatry: How far have we come?. Curr Psychiatry Rep 8, 215–222 (2006). https://doi.org/10.1007/s11920-006-0026-y

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  • DOI: https://doi.org/10.1007/s11920-006-0026-y

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