Advances and perspective in consultation-liaison psychiatry

• Published in: Annales médico psychologiques 2010-04, Vol.168 (3), p.198-204
• Main Author: Consoli, S M
• Format: Article
• Language: eng ; fre
• ISSN: 0003-4487
• DOI: 10.1016/j.amp.2010.02.009

The author addresses three key issues concerning the state of art and the future of consultation-liaison psychiatry. In the context of medico-economic constraints, it is important both to be provided with epidemiological arguments on the prevalence of psychiatric comorbidities in medically ill and their impact on health and sanitary costs, and to seize the opportunity to upgrade consultation-liaison psychiatry, especially through correctly coding of discharge summaries, taking into account such comorbidities, given their impact on hospital receipts. Screening for depressive disorder in medicine remains a priority for consultation-liaison psychiatry. Epidemiology has consistently shown the prognostic value of such symptoms, especially in the cardiovascular field. The relationship between depressive symptoms and cognitive hostility deserve to be better taken into account and can guide the type of follow-up. A growing literature has been devoted to the links between alexithymia, emotional awareness, somatic vulnerability. Several examples are given of the operational nature of these concepts, based on experimental studies, and paths are suggested that open to better understand the links between alexithymia and empathic ability of the patient, but also between empathic ability of the caregiver and therapeutic alliance. These concepts, which refer more to medical psychology than to psychiatric nosography, make the richness of the field of consultation-liaison psychiatry.