Effect of Psychiatric Liaison on Consultation Rates and Reasons for Consult in Gynecologic Oncology

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Abstract
According to prevalence studies, about half of cancer patients have psychiatric disorders. However, only about 2% are referred for psychiatric consultation. Among gynecologic oncology patients, those with ovarian cancer may be particularly vulnerable to depression and anxiety because of their poor prognoses and stressful treatments. With a limited time series design, hospital chart review was used to examine the effect of adding a psychiatric liaison program to a pre-existing consultation service on (1) the overall rate of psychiatric consultation requests for gynecologic cancer patients, (2) the rate of consultations for the sub-group of ovarian cancer patients, and (3) the proportion of consults for ovarian cancer patients requested because of problems with depression and/or anxiety. With liaison there was a significant overall increase in consultation rate for gynecologic oncology patients. Liaison did not influence the consultation rate for ovarian cancer patients in that these patients had higher consultation rates both prior to and after the development of liaison. There was, however, a significant increase in consults for ovarian cancer patients for ‘excessive emotional reaction’ (including symptoms of depression and anxiety). These findings emphasize that a collaborative relationship between a service offering psychiatric care and an oncology service can improve oncologists’ abilities to recognize emotional symptoms.