Evaluation of the socio-demographic and clinical characteristics, referral reasons and follow-up processes of patients referred as outpatients to the consultation-liaison psychiatry clinic of a university hospital

In this study, the sociodemographic and clinical characteristics, reasons for referral, diagnostic distributions, justification for consultation requests, and follow-up status of patients referred from various medical departments to the Consultation-Liaison Psychiatry (CLP) outpatient clinic at Akdeniz University Hospital were comprehensively evaluated. The mean age of the 1028 patients was 50.5 years, and 61.3% were female. While 50.1% of the patients had no prior psychiatric consultation history, this rate was 68.2% among oncology patients. The most frequently reported reasons for referral were depressive symptoms (18.7%) and anxiety symptoms (18.1%). According to the DSM-5 diagnostic classification, depressive disorders (29.0%) and anxiety disorders (23.8%) were the most common diagnoses. Psychiatric follow-up was recommended for 86.1% of the patients; however, 54.8% did not attend the scheduled control appointments regularly. Among the 400 patients who did attend follow-up appointments, clinically significant improvement was observed in 63.3%, and in 77.8% of oncology patients, after a three-month period. On the other hand, 68.8% of oncology patients were unable to continue the follow-up process. Of all referrals, 45.4% were made by the neurology outpatient clinic. This high proportion is associated with the frequent presentation of symptoms such as cognitive changes, behavioral disturbances, and conversion symptoms that overlap with psychiatric manifestations in neurological practice. In approximately half of the consultation requests (52.7%), the stated reason for referral matched the findings of the psychiatric evaluation. In 34.4% of the cases, psychiatric symptoms were detected but did not align with the initial referral reason. In 12.8% of the cases, the consultation was requested without a clear indication for psychiatric assessment. These findings highlight the need to revise consultation request forms and suggest that short-term clinical awareness training integrated into the referral process may help improve the appropriateness of consultation requests. This study draws attention to the high rate of first-time psychiatric referrals within the CLP outpatient population, the relationship between continuity of follow-up and clinical outcomes, and the systemic challenges encountered during the consultation process. To enhance clinical effectiveness, it is recommended to implement regulatory measures that ensure more consistent and appropriate consultation requests and to develop structural improvements that support patients' regular attendance at scheduled follow-up appointments.