The guideline “consultation psychiatry” of the Netherlands Psychiatric Association
Received 24 February 2009; received in revised form 24 February 2009; accepted 3 March 2009. published online 17 April 2009.
Abstract
Background
In 2008, the Netherlands Psychiatric Association authorized a guideline “consultation psychiatry.”
Aim
To set a standard for psychiatric consultations in nonpsychiatric settings. The main objective of the guideline is to answer three questions: Is psychiatric consultation effective and, if so, which forms are most effective? How should a psychiatric consultations be performed? What increases adherence to recommendations given by the consulting psychiatrist?
Method
Systematic literature review.
Results
Both in general practice and in hospital settings psychiatric consultation is effective. In primary care, the effectiveness of psychiatric consultation is almost exclusively studied in the setting of “collaborative care.” Procedural guidance is given on how to perform a psychiatric consultation. In this guidance, psychiatric consultation is explicitly looked upon as a complex activity that requires a broad frame of reference and adequate medical and pharmacological expertise and experience and one that should be performed by doctors. Investing in a good relation with the general practitioner, and the use of a “consultation letter” increased efficacy in general practice. In the hospital setting, investing in liaison activities and an active psychiatric follow-up of consultations increased adherence to advice.
Conclusion
Psychiatric consultations are effective and constitute a useful contribution to the patients' treatment. With setting a standard consultations will become more transparent and checkable. It is hoped that this will increase the quality of consultation psychiatry.
Corresponding author. Department of Psychiatry Maastricht University Medical Center P.O. Box 5800 6202 AZ Maastricht, The Netherlands. Tel.: +31 43 3877443; fax: +31 43 3875444.
1 The first author is chairman of the Dutch guideline on “consultation psychiatry”; the other authors constitute the work group members, listed in alphabetical order, which does not necessarily reflect the extent of the contribution to the guideline.
ABSTRACT