Analysis of psychiatric consultations in the department of neurology and stroke unit: diagnosis and therapy

Abstract

Aim. The aim of this study was to analyze psychiatric consultations of patients hospitalized in the Department of Neurology and Stroke Unit (DN/SU) of University Clinical Center in Katowice from 2017 to 2018. Method. A retrospective analysis of psychiatric consultations, psychiatric diagnoses (according to the ICD-10) and treatment recommendations was done. Results. 719 psychiatric consultations were performed in all hospital departments in the analyzed period. 488 (67.87%) consultations were conducted in the Department of Neurology and Stroke Unit. Most patients who required psychiatric consultations were diagnosed with Huntington’s disease (n = 25; 37.31%), Parkinson’s disease (n = 60; 23.9%) and epilepsy (n = 40; 22.73%). The most common psychiatric diagnoses included organic mental disorders (n = 229; 55.85%), particularly organic mood disorders (n = 73; 14.96%) and organic anxiety disorders (n = 32; 6.56%) whereas in the case of vascular diseases the most common diagnoses included disturbances of consciousness associated with delirium (n = 30; 40.54%). The majority of consultations (n = 388; 79.51%) resulted in the onset or modification of pharmacological treatment. The most frequently prescribed drugs were: neuroleptics (n = 174; 35.66%), mostly atypical (n = 152; 87,36%), and antidepressants (n = 230; 47.13%), mostly SSRIs (n = 216; 93.91%). In patients > 60 years of age organic disorders were more prevalent (n = 179; 66.30% vs. n = 49; 35.0%) and neuroleptics were more frequently prescribed (n = 131; 42.12% vs. n = 44; 24.86%) compared to patients < 60 years. Conclusions. Patients in the department of neurology and stroke unit underwent a psychiatric consultation most frequently. Optimizing the care of a neurological patient is related to close cooperation of a neurologist and a psychiatrist, as well as developing and updating common positions for the management of selected disease entities.