Trends in Inpatient Psychiatry Referrals: A Retrospective Study of Consultation-Liaison Psychiatry Services

Background The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted healthcare delivery, including consultation-liaison psychiatry (CLP) services, by altering patient profiles and referral dynamics. Understanding these changes is crucial for optimizing mental health care within general hospital settings. This study aimed to compare the pattern of CLP referrals among inpatients during the pre-COVID and post-COVID periods. Methods A retrospective chart review was conducted at the All India Institute of Medical Sciences, Patna, India. Data from inpatients referred to the CLP team during March-August 2019 (pre-COVID) and March-August 2022 (post-COVID) were analyzed. Six months was selected because the number of referrals to CLP is relatively low, and a longer duration was required to obtain a meaningful sample size for analysis. Accordingly, we included approximately six months of data from the pre-COVID period and used a comparable timeframe from another year during the pandemic to ensure consistency and allow for valid comparison. Socio-demographic variables, referral sources, psychiatric diagnoses, family history, and comorbid physical illnesses were compared using the chi-square test. Results A total of 285 patients were included in the study. The number of patients seen by the CLP team increased from 107 in the pre-COVID period to 178 in the post-COVID period, representing a 66.4% increase. There was a significant shift in age distribution (p-value = 0.011), with a decrease in patients aged >60 years in the post-COVID period (56 (52.3%) to 57 (32%), p-value = 0.011). Referral patterns shifted, with increased referrals from emergency (7 (6.5%) to 23 (12.9%)) and general medicine (13 (12.1%) to 39 (21.9%)), and decreased referrals from accidents and trauma (16 (15%) to 7 (3.9%), p-value = 0.007). Delirium showed a substantial rise (8 (7.5%) to 54 (30.3%)), while mood disorders (14 (13.1%) to 13 (7.3%)) and psychotic disorders (16 (15%) to 16 (9%)) declined (p-value = 0.0006). Family history of psychiatric illness remained largely unchanged. Conclusion The study demonstrates important shifts in psychiatry referral patterns and patient characteristics following the COVID-19 pandemic. These findings highlight the need for flexible and responsive CLP services within hospital settings. They also provide useful insights for planning mental health services and strengthening preparedness for future public health emergencies.