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Title: Misidentification of mental health symptoms in presence of organic diseases and delirium during psychiatric liaison consulting.
Austin Authors: Otani, Victor Henrique Oyamada;Otani, Thaís Zélia Dos Santos;Freirias, Andrea;Calfat, Elie Leal de Barros;Aoki, Patricia Satiko;Cordeiro, Quirino;Kanaan, Richard A A ;Cross, Sean;Liersch-Sumskis, Susan;Uchida, Ricardo Riyoiti
Affiliation: Department of Mental Health, Santa Casa Medical School, São Paulo, Brazil
Department of Psychiatry, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Maudsley Simulation, South London & Maudsley Foundation NHS Trust , Lambeth Hospital , London , UK
School of Nursing, Faculty of Science, Medicine and Health University of Wollongong , Wollongong , Australia
Issue Date: Sep-2017 2017-03-22
Publication information: International journal of psychiatry in clinical practice 2017; 21(3): 215-220
Abstract: To identify predictors of misidentification of organic mental disorders and delirium in patients undergoing psychiatric liaison consultation. Data were collected at Santa Casa de São Paulo between July of 2009 and March of 2013. We included in our analysis all inpatients for whom the requesting service judged that a psychiatric consultation was required for a possible mental health condition. Outcomes of interest were the instances of misidentification where a condition was initially deemed to be of a psychiatric nature, whereas the final diagnosis by the liaison psychiatric team was of an organic disease or delirium. Our predictors were the clinical specialty of the requesting service, requester and patient characteristics. A series of generalised linear models were used to evaluate misidentification risks. A total of 947 subjects met our inclusion criteria, 14.6% having a final liaison diagnosis of organic mental disorder and 8.1% of delirium. Older patients were significantly associated with increased risk of misidentification for both organic conditions (OR 3.01 - 95% CI 2.01, 4.5) and delirium (OR 3.92 - 2.4, 6.39). Educational interventions in general hospitals focused on preventing psychiatric misdiagnosis should target in-hospital services where patients tend to be older.
DOI: 10.1080/13651501.2017.1301483
ORCID: 0000-0003-0992-1917
Journal: International journal of psychiatry in clinical practice
PubMed URL: 28326870
Type: Journal Article
Subjects: Diagnostic errors
referral and consultation
Appears in Collections:Journal articles

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