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Audit of the first year of a psychiatric clinic at a Dublin Maternity Hospital

Published online by Cambridge University Press:  13 June 2014

Miriam Gannon ,
Siobhan Barry  and
Michael Turner
Siobhan Barry
Affiliation:
Cluain Mhuire Service, Blackrock, Co Dublin and Visiting Consultant Psychiatrist, Coombe Women's Hospital, Dublin 8, Ireland.
Michael Turner
Affiliation:
Coombe Women's Hospital, Dublin 8, Ireland.
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Abstract

Objectives: The aims of the audit were to monitor the activities of the liaison clinic over a 12 month period, to establish the number of attenders and non-attenders and to evaluate whether the service was meeting the needs of patients with perinatal disorders.

Method: The Coombe Women's Hospital is one of three maternity hospitals in Dublin and had 6,452 deliveries and 5,273 inpatient gynaecological procedures performed in 1994. The charts of all the patients who were given an appointment for the psychiatric clinic between January 1 and December 31, 1994 were reviewed.

Results: Fifty-six patients attended the clinic over the 12 month period, 38(68%) of whom were new referrals to the service. Twenty-two patients were antenatal, 20 were postnatal and 14 patients were attending the gynaecology department. Seventeen patients (30%) who were referred to the clinic failed to attend for their first appointment. Forty-one (73%) patients had sufficient symptomatology to make an ICD-10 diagnosis. Medication was prescribed for 58% of those who attended. Four patients were referred to their catchment area service for inpatient care: six patients were referred to their catchment area service for further outpatient care as they had psychiatric illnesses which predated their pregnancies.

Conclusions: The number of patients referred to the liaison service with postnatal depression is remarkably less than that anticipated and there is a high rate of defaulting among first attenders. Various recommendations are made to improve the effectiveness of the service.

Keywords

AuditLiaisonPsychiatric service
Type
Audit
Information
Irish Journal of Psychological Medicine , Volume 15 , Issue 4 , December 1998 , pp. 142 - 144
Copyright
Copyright © Cambridge University Press 1998

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References

1.Kumar, R, Robson, K. A prospective study of emotional disorders in childbearing women. Br J Psychiatry 1984; 144: 35–47.CrossRefGoogle ScholarPubMed
2.Kendell, RE, Chalmers, L, Platz, C. The epidemiology of puerperal psychoses. Br J Psychiatry 1987; 150: 662–73.CrossRefGoogle ScholarPubMed
3.Cox, JL, Connor, LM, Kendell, RE. Prospective study of psychiatric disorders of childbirth. Br J Psychiatry 1982; 140: 111–7.CrossRefGoogle ScholarPubMed
4.Oates, M. The development of an integrated community-orientated service for severe postnatal mental illness. In; Kumar, R, Brockington, IF, eds. Motherhood and mental illness. London: Wright, 1988: 2.Google Scholar
5.Oates, M. Postnatal mental illness: organisation and function of a psychiatry service. In: Cox, J, Holden, J, eds. Aspects of perinatal psychiatry: use and misuse of the Edinburgh Postnatal Depression Scale. London: Gaskill, 1994.Google Scholar
6.Martin, M. A maternity hospital study of psychiatric illness associated with childbirth. Ir J Med Sci 1977; 146: 239–44CrossRefGoogle ScholarPubMed
7.Stein, A, Gath, DH, Bucher, J, Bond, A, Day, A, Cooper, PJ. The relationship between postnatal depression and mother-child interaction. Br J Psychiatry 1991; 158: 46–52CrossRefGoogle ScholarPubMed
8.Cox, JL. Depression in the puerperium: a conceptual controversy. In: Herbst, K, Paykel, E, eds. Depression: An integrative approach. Oxford: Heineman Medical Books, 1989.Google Scholar
9.Report of the general psychiatry section working party on postnatal mental illness. Psychiatr Bull 1992; 16: 519–22.CrossRefGoogle Scholar
10.Ryan, MM, Dennerstein, L, Pepperell, R. Psychological aspects of hysterectomy. Br J Psychiatry 1989; 154: 516–22.CrossRefGoogle ScholarPubMed
11.Ballinger, CB. Psychiatric aspects of the menopause. Br J Psychiatry 1990; 156: 773–87.CrossRefGoogle ScholarPubMed
12.Mayou, R, Hawton, K. Psychiatric disorder in the general hospital. Br J Psychiatry 1986; 149: 172–90.CrossRefGoogle ScholarPubMed
13.Friedman, T, Gath, D. The psychiatric consequences of spontaneous abortion. Br J Psychiatry 1989; 155: 810–3.CrossRefGoogle ScholarPubMed
14.Forest, G, Standizer, E, Baum, J. Support after perinatal death; a study of support and counseling after perinatal bereavement. BMJ 1982; 2: 1475–9.CrossRefGoogle Scholar
15.Robinson, GE, Stewart, DE, Flak, E. The rational use of psychotropic drugs in pregnancy and postpartum. Can J Psychiatry 1986; 31: 183–90.CrossRefGoogle ScholarPubMed
16.Cox, JL, Holden, JM, Sagovsky, R. Detection of postnatal depression – development of the 10 item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782–6.CrossRefGoogle ScholarPubMed
17.Brockington, IF, Cernil, KF, Schofield, EMet al.Puerpal psychosis: phenomena and diagnosis. Arch Gen Psychiatr 1981; 38: 929–33.CrossRefGoogle Scholar
18.O'Hara, MW. Social support, life events and depression during pregnancy and the puerperium. Arch Gen Psychiatr 1986; 43: 569–73CrossRefGoogle ScholarPubMed
19.Murray, D, Cox, JL. Screening for depression during pregnancy with the Edinburgh Depression Scale (EPDS). J Reprod Infant Psychol 1990; 8: 99–109.CrossRefGoogle Scholar
20.Munjal, A, Latimer, M, McCune, N. Attendance at child psychiatry new patient clinics. Ir J Psych Med 1994; 11: 182–4.CrossRefGoogle Scholar
21.Woods, JP. Can psychiatrists predict which new referrals will fail to attend? Psychiat Bull 1992; 16: 18–19.CrossRefGoogle Scholar
22.Hellewell, J, Pugh, E. Predicting new patient nonattendence (letter). Psychiat Bull 1992; 16: 306.CrossRefGoogle Scholar
23.Lefebvre, A, Sommerauer, J, Cohen, N, Waldron, S, Perly, I. Where did all the ‘no shows’ go? Can J Psychiatry 1983; 28: 387–90.CrossRefGoogle ScholarPubMed