Integration of psychiatry into palliative care units: Retrospective analysis of psychiatric consultation reasons and diagnoses by age and gender, with a treatment overview

将精神科纳入姑息治疗单元:按年龄和性别回顾性分析精神科会诊原因和诊断,并概述治疗情况

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Abstract

The objective of this study was to investigate psychiatry consultations for patients in a palliative care unit, comparing consultation reasons and diagnoses after psychiatrists' consultations according to age and gender, and to describe the treatments provided by psychiatrists. This study, designed as a retrospective, descriptive, and cross-sectional, involved 97 patients who were hospitalized in the palliative care unit of Turkey Kirsehir Training and Research Hospital between September 2023 and September 2024. Data were obtained from hospital medical records. Statistical analyses were performed to compare the clinical characteristics of the patients, consultation reasons, and diagnoses after psychiatrists' consultations according to age and gender. Statistical analyses were performed using IBM SPSS Statistics version 20.0, and a P-value <.05 was considered statistically significant. The most common reason for palliative care unit consultation to psychiatry was agitation, and the most common diagnosis made by psychiatrists was sleep disorders. The most frequently used treatment for sleep disorder is quetiapine (83.3%). A statistically significant difference was identified in anxiety diagnoses between female and male patients (P = .004), with higher rates observed in females. Delirium diagnosis was found to be significantly more prevalent in patients aged ≥65 years compared to those aged 18 to 64 (P = .025). Also, non-psychiatric organic causes (pain, dyspnea, fatigue, loss of appetite etc) were significantly more common in males than in females (P = .027) and in patients aged 18 to 64 than in patients aged ≥ 65 (P = .019). The main conclusion of this study can be summarized as including psychiatrists in palliative care unit team or communicating with them to ensure effective treatment for diagnoses such as sleep disorders, delirium, anxiety disorders, and depression, which are commonly encountered in palliative care units and can be interpreted as early signs of worsening patient prognosis.

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