2026 ECNP Congress

EP01-1005

The role of consultation-liaison psychiatry in the management of patients with alcohol use disorder and alcohol related gastrointestinal complications

Jelena Branković — N.M. Stojanović, M. Petković, G. Nikolić, O. Žikić · Faculty of Medicine- University of Niš- Serbia, Department of Psychiatry with Medical Psychology, Niš, Serbia

2026 ECNP Congress

Introduction: Consultation-liaison psychiatry (CLP) is defined by Lipowski as the area of clinical psychiatry that includes diagnostic, therapeutic, teaching, as well as research activities of psychiatrists in the nonpsychiatric medical settings [1]. The main focus of CLP are psychiatric comorbidities in medically ill hospitalised patients [2]. A recent study from a Regional Australian Hospital showed that psychiatric consulting service was primarily required to provide a diagnosis and pharmacological management advice to physicians [3]. The Consultation versus Liaison Psychiatry Study in Germany demonstrated that the most common psychiatric comorbidities in somatically ill hospitalised patients are affective disorders, organic mental disorders as well as alcohol-induced mental disorders and reactions to severe stress or adjustment disorders [4]. We investigated which kinds of alcohol related gastrointestinal complications occur most frequently in patients with alcohol use disorder on the Gastroenterology and Hepatology Ward at the University Clinical Center Niš in Serbia.

Methods: A retrospective examination of medical records over a two year period (2023 – 2025) was performed in order to determine the frequency of alcohol related gastrointestinal complications in patients with alcohol use disorder admitted to the Gastroenterology and Hepatology Ward of the University Clinical Centre Niš, a medium-sized tertiary care center, where psychiatric care is provided in a consultation-based approach with consultation services operating 24/7, meaning that at any time an in-house psychiatric consultation for a patient could be requested.

Results: Out of total number of examined patients (n=260) at the gastroenterology clinic 65 (25%) were diagnosed with alcohol use disorder needing psychiatric consultation due to certain psyche decompensation. In this studied group of patients with alcohol use disorder 64% were hospitalized due to liver decompensation, 10% due to oesophageal varices with bleeding, 10% due to acute pancreatitis and 4.5% due to gastric bleeding. The remaining were due to other unspecific gastrointestinal issues, still undiagnosed. Cirrhosis was diagnosed in 45% of the 65 examined patients with alcohol use disorder. Alcohol-related liver disease (ALD) was the most common alcohol related gastrointestinal complication among patients with alcohol use disorder in the study sample.

Conclusions: The University Clinical Centar Niš, a medium-sized tertiary care center, aimed to improve and coordinate care for patients with alcohol use disorder and alcohol related gastrointestinal complications by recruiting a collaborative multidisciplinary team and placing the patient at the centre of all efforts. CLP is uniquely positioned at the junction of somatic medicine and psychiatry to lead future efforts in the study and care of alcohol related gastrointestinal diseases. Various factors contribute to inadequate treatment for alcohol related gastrointestinal diseases such as low multidisciplinary collaboration, medical and psychiatric complexity, provider shortages, stigma [5]. No single discipline is sufficiently equipped to manage the complexity of alcohol related gastrointestinal disorders given its psychiatric and somatic components.

References

  1. Lipowski, Z.J., 1967. Review of consultation psychiatry and psychosomatic medicine. I. General principles. Psychosomatic medicine, 29 (2), 153–171. doi: 10.1097/00006842-196703000-00007.
  2. Hopkins, J.R., Skudder, E., Sundram, F., Cullum, S., 2023. A survey of the psychiatric care provided for medically ill older adults in general hospitals in New Zealand. Australas Psychiatry 31 (4), 485-493. doi: 10.1177/10398562231186132.
  3. Tan, C., Reelh, S., Suri, R., Hiskens, M., Ajit, A., Rana, A., 2024. A multifaceted assessment of the consultation liaison psychiatry service within a regional australian hospital. Healthcare (Basel) 12 (22), 2250. doi: 10.3390/healthcare12222250.
  4. Lücke, C., Gschossmann, J.M., Schmidt, A., Gschossmann, J., Lam, A.P., Schneider, C.E., et al., 2017. A comparison of two psychiatric service approaches: findings from the consultation vs. liaison psychiatry-study. BMC Psychiatry 17 (1), 8. doi: 10.1186/s12888-016-1171-4.
  5. Winder, G.S., Fernandez, A.C., Klevering, K., Mellinger, J.L, 2020. Confronting the crisis of comorbid alcohol use disorder and alcohol related liver disease with a novel multidisciplinary clinic. Psychosomatics 61 (3), 238-253. doi: 10.1016/j.psym.2019.12.004.