Browsing by Author "Creed, F"
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- Consultation-Liaison psychiatric service delivery: results from a European studyPublication . Huyse, F; Herzog, T; Lobo, A; Malt, U; Opmeer, B; Stein, B; Jonge, P; Dijck, R; Creed, F; Crespo, MD; Cardoso, GThe reported findings of the European Consultation-Liaison Workgroup (ECLW) Collaborative Study describe consultation-liaison service delivery by 56 services from 11 European countries aggregated on a C-L service level. During the period of 1 year (1991), the participants applied a standardized, reliability tested method of patient data collection, and data were collected describing pertinent characteristics of the hospital, the C-L service, and the participating consultants. The consultation rate of 1% (median; 1.4% mean) underscores the discrepancy between epidemiology and the services delivered. The core function of C-L services in general hospitals is a quick, comprehensive emergency psychiatric function. Reasons to see patients were the following. deliberate self-harm (17%), substance abuse (7.2%), current psychiatric symptoms (38.6%), and unexplained physical complaints (18.6%) (all means). A significant number of patients are old and seriously ill. Mood disorders and organic mental disorders are most predominant (17.7%). Somatoform and dissociative disorders together constitute 7.5%. C-L services in European countries are mainly emergency psychiatric services and perform an important bridge function between primary, general health, and mental health care.
- European Consultation-Liaison Psychiatric Services: the ECLW Collaborative StudyPublication . Huyse, F; Herzog, T; Lobo, A; Malt, U; Opmeer, B; Stein, B; Creed, F; Crespo, MD; Cardoso, G; Guimarães-Lopes, R; Mayou, R; van Moffaert, M; Rigatelli, M; Sakkas, P; Tienari, POBJECTIVE: To describe the patterns of organization of consultation-liaison (C-L) services in 11 European countries in relation to hospital characteristics and national approaches to C-L psychiatry. METHOD: Cross-sectional survey. RESULTS: Services can best be described in terms of their size and seniority of their staff and whether or not they are multidisciplinary. Single-discipline services are based upon the standard medical consultant model, whereas those with multidisciplinary teams work in a way that is comparable with community mental health teams. German psychosomatic C-L services belonged to either model. National differences were found. CONCLUSION: This first international study provides empirical evidence for the wide variation in the organization of C-L services. In view of the increasing numbers of patients with psychiatric disorder who are being treated in general hospitals and the changing patterns of medical care there are important implications for clarification and improvement of the role of C-L services.
- European guidelines for training in consultation-liaison psychiatry and psychosomatics: report of the EACLPP Workgroup on Training in Consultation-Liaison Psychiatry and PsychosomaticsPublication . Sollner, W; Creed, F; European Association of Consultation–Liaison Psychiatry; Psychosomatics Workgroup on Training in Consultation–Liaison; Cardoso, GOBJECTIVE: The European Association of Consultation-Liaison Psychiatry and Psychosomatics (EACLPP) has organized a workgroup to establish consensus on the contents and organization of training in consultation-liaison (C-L) for psychiatric and psychosomatic residents. METHODS: Initially, a survey among experts has been conducted to assess the status quo of training in C-L in different European countries. In several consensus meetings, the workgroup discussed aims, core contents, and organizational issues of standards of training in C-L. Twenty C-L specialists in 14 European countries participated in a Delphi procedure answering a detailed consensus checklist, which included different topics under discussion. RESULTS: Consensus on the following issues has been obtained: (1) all residents in psychiatry or psychosomatics should be exposed to C-L work as part of their clinical experience; (2) a minimum of 6 months of full-time (or equivalent part-time) rotation to a C-L department should take place on the second part of residency; (3) advanced training should last for at least 12 months; (4) supervision of trainees should be clearly defined and organized; and (5) trainees should acquire knowledge and skills on the following: (a) assessment and management of psychiatric and psychosomatic disorders or situations (e.g., suicide/self-harm, somatization, chronic pain and psychiatric disorders, and abnormal illness behavior in somatically ill patients); (b) crisis intervention and psychotherapy methods appropriate for medically ill patients; (c) psychopharmacology in physically ill patients; (d) communication with severely ill patients and dying patients, as well as with medical staff; (e) promotion of coordination of care for complex patients across several disciplines; and (f) organization of C-L service in relation to general hospital and/or primary care. In addition, the workgroup elaborated recommendations on the form of training and on assessment of competency. CONCLUSION: This document is a first step towards establishing recognized training in C-L psychiatry and psychosomatics across the European Union.