The role of consulting psychiatrists for obstetric and gynecologic inpatients.

BACKGROUND: The purpose of this study was to investigate the consultation psychiatry service to the Obstetrics and Gynecology Department in a general hospital, focusing on referral patterns and consultation recommendations. METHOD: A retrospective review of the medical charts and consultation records of obstetric and gynecological patients referred for psychiatric consultation from Dec. 2003 to Nov. 2009 was performed. RESULTS: One hundred and eleven patients were referred during the 6-year period, a psychiatric referral rate of 0.11% among 99,098 obstetric and gynecologic admissions. Obstetric and gynecologic consultations comprised 0.64% of all psychiatric consultations. The most common reasons for referral were depression (52.25%), past psychiatric history (31.53%), insomnia (29.73%) and confusion (24.32%). The most common DSM-IV psychiatric diagnoses were depressive disorder (37.84%), schizophrenia and other psychoses (20.72%), delirium (17.12%) and adjustment disorder (10.81%). The most frequent physical diagnoses of referred patients were neoplasms (72.97%), infectious diseases (42.34%) and complications of pregnancy and puerperium (17.12%). Recommendations included pharmacological intervention (89.19%) and psychological management (72.07%). CONCLUSION: The psychiatric referral rate of obstetric and gynecological inpatients was relatively low compared with that of other departments. More collaboration and liaison between gynecologists and consultation psychiatrists may provide better care for obstetric and gynecological inpatients.

Elevated serum cholesterol levels in women with premenstrual dysphoric disorder.

OBJECTIVES: To study the association of premenstrual serum total cholesterol level (TC) with premenstrual dysphoric disorder (PMDD). METHOD: The premenstrual serum cholesterol levels of 34 patients with PMDD and 20 normal controls were measured, and the rates ofhypercholesterolemia in the 2 groups were compared. RESULTS: The mean of the premenstrual cholesterol level of the study group was 180.82 +/- 34.47 mg/dL, while that of the control group was 162.45 +/- 21.29 mg/dL (t = 2.152, df = 52, p = 0.036). The prevalence of premenstrual hypercholesterolemia (serum total cholesterol > 200 mg/dL) was 23.53% (8/34) in the PMDD group and zero in the normal control group (chi-square = 5.524, df = 1, p = 0.019). CONCLUSION: The results showed elevated premenstrual serum cholesterol in PMDD and implied a new direction of research to further explore the etiology of PMDD. It is suggested that the pathophysiology of premenstrual dysphoric disorder may be similar to that of anxiety disorders.