Comparing consultation-liaison psychiatrist's and neurologist's approaches to delirium - A retrospective analysis.
To compare the diagnostic, management, and treatment recommendations made by consultation-liaison psychiatrists (CLP) and neurologists (CLN) for suspected delirium and to investigate factors that may have influenced the choice for a particular consultation service.



In this retrospective case analysis, we screened the files of 1882 (CLP: 1112, CLN: 770) inpatients seen by CLP and CLN at the Charité - University Medicine, Berlin, Germany, in 2013. This revealed a total of 148 (CLP: 99, CLN: 49) delirium patients. Information found on the consultation form and in the patients' files was used for data collection and subsequently analyzed.



Intensive care and surgical units preferably called CLP, while internists consulted more CLN and patients suffering from neurological or psychiatric preconditions were more often seen by the respective specialist. Despite no significant difference between psychomotor activity levels among the groups, CLP recommended significantly more pharmacological interventions (p = 0.000) and CLN ordered significantly more diagnostic procedures (p = 0.000).



Our results show considerable differences between CLP and CLN treatment recommendations, which may indicate a conflicting approach to delirium work-up, not accountable to unequal patient characteristics. These preliminary results are not conclusive and should be followed up by high evidence level research.
Department of Psychiatry and Psychoherapy, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
Marie Rosa
MR
Mews
Department of Psychiatry and Psychoherapy, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
Deborah
D
Tauch
Department of Neurology, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
Hebun
H
Erdur
Department of Psychiatry and Psychoherapy, Charité - University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany Department of Psychiatry and Psychotherapy, Friedrich von Bodelschwingh-Klinik, Berlin, Germany arnim.quante@charite.de.
Arnim
A
Quante
D003693:Delirium / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007297:Inpatients / Q000523:psychology; D000072141:Neurologists; D010818:Practice Patterns, Physicians'; D011570:Psychiatry; D012017:Referral and Consultation; D012189:Retrospective Studies
consultation psychiatry; delirium; general hospital; primary care