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EV0384

Consultation-liaison psychiatry at a public hospital in Cambodia: a retrospective analysis of referral patterns and clinical challenges

PSYCHIATRIC LIAISON CONSULTATIONS IN A CAMBODIAN GENERAL HOSPITAL: A RETROSPECTIVE ANALYSIS OF REFERRAL PATTERNS AND CLINICAL CHALLENGES

Among 1,037 consultation-liaison psychiatry consultations conducted over one year at a tertiary hospital in Cambodia, referrals came predominantly from medical departments, presenting complaints were frequently somatic in nature, and the most common diagnosis was alcohol dependence syndrome.

The study aimed to describe the patient profile, referral sources, distribution of ICD-10 diagnoses, and operational challenges of a consultation-liaison psychiatry (CLP) service at a tertiary public hospital in Cambodia; the hospital had no structured CLP record-keeping system before 2024. In a retrospective descriptive analysis of all CLP consultations recorded during the 2024 calendar year at Khmer-Soviet Friendship Hospital in Phnom Penh, 1,037 of 1,126 referral requests (92.1%) were included in the study; the mean age was 44.8 years (range: 12–89), 50.6% of patients were female and 49.4% were male, and 58% were from rural areas. The most frequent referring departments were internal medicine (258; 24.9%), the emergency department (199; 19.2%), gastroenterology (138; 13.3%), pulmonology (101; 9.7%), and surgery and cardiology (80; 7.8%). The most common presenting complaints were agitation or restlessness (129; 12.5%), sleep disturbance (128; 12.3%), chest tightness (100; 9.6%), behavioral disturbance (100; 9.6%), and confusion (95; 9.2%). The distribution of ICD-10 diagnoses, excluding 127 cases of delirium, included alcohol dependence syndrome in 133 cases (12.8%), anxiety disorders in 91 (8.8%), major depression in 57 (5.5%), and schizophrenia in 52 (5.0%). The authors note that somatic complaints such as sleep problems (12.3%) and chest tightness (9.6%) provide a culturally acceptable entry point into mental health care by circumventing psychiatric stigma, and that the high burden of alcohol dependence (12.8%) calls for addiction services integrated into the hospital. Misidentification of delirium, incomplete referral information, and communication gaps were identified as the main operational barriers; in the short term, the hospital plans to introduce standardized, template-based referral protocols and diagnostic training for ward physicians, followed in the medium term by addiction management pathways and systematic outcome monitoring. The background highlights that psychiatric comorbidity is present in up to 46% of medical inpatients and often remains undetected in the absence of a liaison service.

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