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Liaison psychiatry, also known as consultative psychiatry or consultation-liaison psychiatry is the branch of psychiatry
Psychiatry

Psychiatry is a Medicine Specialty devoted to the Treatment of mental disorders, Biomedical research and Prevention of mental disorder. The term was first coined by the German physician Johann Christian Reil in 1808....
 that specialises in the interface between medicine
Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
 and psychiatry, usually taking place in a hospital or medical setting. Liaison psychiatry has areas of overlap with other distinct disciplines including psychosomatic medicine, health psychology
Health psychology

Health psychology is concerned with understanding how biology, behavior, and social context influence health and illness. Health psychologists work alongside other medical professionals in clinical settings, work on behaviour change in public health promotion, teach at universities, and conduct research....
 and neuropsychiatry
Neuropsychiatry

Neuropsychiatry is the branch of medicine dealing with mental disorders attributable to diseases of the nervous system.It preceded the current disciplines of psychiatry and neurology, in as much as psychiatrists and neurologists had a common training ....
. The role of the consultation-liaison psychiatrist is to see patients currently admitted as general medical inpatients at the request of the treating medical or surgical consultant or team.






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Liaison psychiatry, also known as consultative psychiatry or consultation-liaison psychiatry is the branch of psychiatry
Psychiatry

Psychiatry is a Medicine Specialty devoted to the Treatment of mental disorders, Biomedical research and Prevention of mental disorder. The term was first coined by the German physician Johann Christian Reil in 1808....
 that specialises in the interface between medicine
Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
 and psychiatry, usually taking place in a hospital or medical setting. Liaison psychiatry has areas of overlap with other distinct disciplines including psychosomatic medicine, health psychology
Health psychology

Health psychology is concerned with understanding how biology, behavior, and social context influence health and illness. Health psychologists work alongside other medical professionals in clinical settings, work on behaviour change in public health promotion, teach at universities, and conduct research....
 and neuropsychiatry
Neuropsychiatry

Neuropsychiatry is the branch of medicine dealing with mental disorders attributable to diseases of the nervous system.It preceded the current disciplines of psychiatry and neurology, in as much as psychiatrists and neurologists had a common training ....
. The role of the consultation-liaison psychiatrist is to see patients currently admitted as general medical inpatients at the request of the treating medical or surgical consultant or team. This is known as a 'consult' and constitutes the consultation facet of the role.

Scope


"Consults" occur when the primary care team has questions about a patient's mental health, or how that patient's mental health is affecting his or her care and treatment. The psychiatric team works as a "liaison" between the medical team and the patient. Issues that arise include assessing the capacity
Capacity (law)

The capacity of both natural person and artificial person persons determines whether they may make binding amendments to their rights, duty and obligations, such as getting marriage or Mergers and acquisitions, entering into contracts, making gift , or writing a valid will ....
 of a patient to consent to treatment, attempting to settle conflicts between patients with the primary care team, and the intersection of problems in both physical and mental health, as well as patients who may report physical symptoms as a result of a mental disorder, and assessing patietns for abnormal illness behaviour. Delirium
Delirium

Delirium is an acute and relatively sudden decline in attention-focus, perception, and cognition. In medical usage it is not synonymous with drowsiness, and may occur without it....
 is commonly diagnosed and treated by psychiatrists. Finally, patients who have attempted suicide
Suicide

Suicide is the intentional taking of one's own life. Many dictionaries also note the metaphorical sense of "willful destruction of one's self-interest"....
 and subsequently admitted for medical treatment are generally treated by this field.

In some hospitals, the Consultation-liaison psychiatry team also covers psychiatric presentations to the Emergency Department, while in others doctors from the psychiatric unit will cover this area.

History

The history of liaison psychiatry is partly a history of psychiatry and medicine. Galen
Galen

Aelius Galenus or Claudius Galenus , better known as Galen of Pergamum , was a prominent Ancient Rome physician and philosopher of Greek origin, and probably the most accomplished medical researcher of the Roman period....
 was highly influential for over 1500 years in medicine particularly advocating the use of experimentation to advance knowledge. The polymath physician Avicenna
Avicenna

, known as Abu Ali Sina Balkhi or Ibn Sina and commonly known in English by his Latinized name Avicenna , was a Persian people polymath and the foremost Islamic medicine and Early Islamic philosophy of his time....
 produced many insights into medicine but only became influential in Western medicine when William Harvey
William Harvey

William Harvey was an English physician who was the first in the Western world to describe correctly and in exact detail the systemic circulation and properties of blood being pumped around the body by the heart....
's elucidation of the circulatory system forced a re-evaluation of Galen
Galen

Aelius Galenus or Claudius Galenus , better known as Galen of Pergamum , was a prominent Ancient Rome physician and philosopher of Greek origin, and probably the most accomplished medical researcher of the Roman period....
's work. The French philosopher Rene Descartes
René Descartes

Ren? Descartes , , also known as Renatus Cartesius , was a French philosophy, mathematician, scientist, and writer who spent most of his adult life in the Dutch Republic....
 began the dualistic debate on the division between mind and body. Johann Christian August Heinroth is credited with the origination of the term psychosomatic illness. At the beginning of the 19th century Johann Christian Reil
Johann Christian Reil

Johann Christian Reil was a Germans physician, physiologist, anatomist and psychiatrist. He coined the term the term psychiatry or, in German, psychiatrie in 1808....
 created the term psychiatry whilst the polymath Benjamin Rush
Benjamin Rush

Benjamin Rush was a Founding Fathers of the United States of the United States. Rush lived in the U.S. state of Pennsylvania and was a physician, writer, Education in the United States, Humanitarianism and a devout Christian, as well as the founder of Dickinson College in Carlisle, Pennsylvania....
 wrote Diseases of the Mind. The philosopher Spinoza's concept of conation
Conation

Conation is a term of relatively recent origin that is synonymous with motivation/will/drive, the preferred terms in psychological discourse. From the Latin verb "conari" which means to attempt or to strive....
, Mesmer's development of hypnosis
Hypnosis

Hypnosis is a mental state or set of attitudes usually induced by a procedure known as a hypnotic induction, which is commonly composed of a series of preliminary instructions and suggestions....
 together with Charcot
Charcot

'Charcot' is the surname of some prominent people:*Jean-Martin Charcot - French neurologist*Jean-Baptiste Charcot - French explorer...
's refinement of this technique influenced Sigmund Freud
Sigmund Freud

Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian psychiatrist who founded the psychoanalysis of psychology. Freud is best known for his theories of the unconscious mind and the defense mechanism of Psychological repression and for creating the clinical practice of psychoanalysis for curing psychopathology through dialogue...
 whose development of psychoanalytic theory
Psychoanalytic theory

Psychoanalytic theory is a general term for approaches to psychoanalysis which attempt to provide a conceptual framework more-or-less independent of clinical practice rather than based on empirical analysis of clinical cases....
 was to have a profound impact on the development of liaison psychiatry. Under the guidance of Alan Gregg, psychoanalysis impacted on hospital medicine through figures such as Franz Alexander
Franz Alexander

Franz Gabriel Alexander January 22 1891 - March 8 1964) was an Hungarian people United States psychoanalyst and physician, who is considered one of the founders of the Psychosomatic medicine, and the psychoanalytic criminology....
, Stanley Cobb
Stanley Cobb

Stanley Cobb was a neurologist and could be considered "the founder of biological psychiatry in the United States".Cobb's childhood and education were affected by his stammer, which it is suggested led him to study the neurosciences in an attempt to understand its cause....
 and Felix Deutsch.

Edward Billings first coined the term "liaison psychiatry." The publishing of two texts A Handbook of Elementary Psychobiology and Psychiatry, by Billings, and Psychosomatic Medicine, by Edward Weiss and O Spurgeon English, outlined the theoretical foundations for the developing field. George L. Engel
George L. Engel

George Libman Engel was an United States psychiatrist. He spent most of his career at the University of Rochester Medical Center in Rochester, New York....
 is considered to have been one of the most important figures in the development of liaison psychiatry and coined the term "Biopsychosocial Model" which overcame divisions created by Cartesian Dualism and was to have wider repercussions on psychiatric practice.

In the United Kingdom
United Kingdom

The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom , the UK or Britain,is a sovereign state located off the northwestern coast of continental Europe....
, the Faculty of Liaison Psychiatry was established within the Royal College of Psychiatrists
Royal College of Psychiatrists

The Royal College of Psychiatrists is the main professional organisation of psychiatrists in the United Kingdom and the Republic of Ireland, responsible for representing and certifying psychiatrists, psychiatric training and providing high quality public information about mental health problems....
 in 1997. The European Association for Consultation Liaison Psychiatry and Psychosomatics also produced a set of guidelines for training in Liaison Psychiatry. The American Psychiatric Association
American Psychiatric Association

The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential world-wide....
 formally recognized C-L psychiatry as a subspecialty in 2004, with its own sub-specialty board exam. The profession debated about the best term for this specialty, finally settling on "Psychosomatic Medicine".

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