adverse effects) as well as depressive, anxiety, and substance use disorders.
The most common disorders in the general medical setting include dementia, delirium, other neurocognitive disorders (eg, the sequelae of traumatic brain injury), catatonia, substance use disorders, intoxication and withdrawal states, and medical complications of psychiatric interventions (eg, neuroleptic malignant syndrome, serotonin syndrome, medication toxicity states. The general medical context of consultation-liaison psychiatry practice means that the psychiatric illness profile differs from that of general psychiatry practice. In addition to psychiatric comorbidity, there is a broad area of psychiatric adverse effects of systemically administered medications (eg, corticosteroids, other immunomodulators, CNS-active agents) and the often complicated systemic medical and psychiatric adverse effects of medications used for primary psychiatric illness (eg, anticonvulsants, lithium, antipsychotics, antidepressants). Examples include the psychiatric comorbidity of neurological illnesses (eg, Parkinson disease, multiple sclerosis, cerebrovascular disease), endocrinological illness (eg, diabetes mellitus, hyper- or hypothyroidism), rheumatic illness (eg, systemic lupus erythematosus, giant cell arteritis), and cardiovascular illness (eg, heart disease, vascular disease). This metaphor reflects consultation-liaison’s place as the most forward clinical psychiatry service in the wider medical world and the opportunity to lead improvements in patient care in all medical services.Ĭonsultation-liaison psychiatrists specialize in the diagnosis and management of psychiatric disorders that are comorbid with general medical/surgical illness. FROM THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRYĬonsultation-liaison (C-L) psychiatry is a major psychiatric subspecialty that, within general medical/surgical and academic medical and increasingly in primary care settings, serves as the “tip of the spear” for psychiatry.
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