(195) Consultation-Liaison Psychiatry and the Social Sciences

Abstract: Background/Significance
There was debate around the name “consultation-liaison psychiatry” (CLP), which was renamed from psychosomatic medicine in 2017. The name “psychosomatics” traditionally defined a holistic integrative approach. This included a focus on the social sciences that once formed part of the biopsychosocial focus indicated by the term “psychosomatic.” The rebrand raised questions about whether this marked a realignment of the field towards a more biomedical focus (Boland, 2018). Our study seeks to investigate these changes, aiming to determine if the literature and research in CLP have indeed evolved away from the social sciences.

Methods
A comprehensive literature review was performed to determine any change in the field’s focus towards or away from the social sciences, as defined by Staur (2013). Search terms used included: (“consultation liaison” OR “psychosomatics” OR “psychiatry”) AND (“anthropology” OR “criminology” OR “economics” OR “history” OR “political science” OR “psychology” OR “sociology”) in the abstract or title. We selected articles from key journals—the Journal of the Academy of Consultation Liaison Psychiatry (JACLP), General Hospital Psychiatry, and Psychosomatics published up to December 31st, 2023. Initial search yielded 8,139 articles, which were refined to 186 articles for final analysis after screening with Rayyan AI software. Two authors (MA, HS) were blinded while reviewing abstracts. Conflicts were resolved by a third author (TA). Our analysis employed IBM SPSS for statistical testing and a thematic analysis framework to explore the evolving themes within the field.

Results
The study reviewed 186 articles and found an uptick in social sciences-related publications post-renaming, from an average of 3.44 to 4.43 articles/year. Notably, discussions around economics shifted significantly after 2017. Initially, articles concentrated on justifying costs and the necessity of psychiatric consultation services in hospitals. Post-change, the focus broadened to explore the wider economic impact and advantages of CLP. However, the general thematic spread across social sciences remained statistically unchanged (p=0.486), suggesting a steady interest in these areas over time.

Discussion
The analysis revealed a distinct evolution in the discussion around economics within CLP, highlighting the field’s potential for contributing to healthcare economics. This shift suggests that the specialty's growth is increasingly recognized not just for its clinical benefits but also for its economic advantages, encouraging further investment in CLP. The lack of significant thematic changes in other social sciences might suggest that CLP continues to embrace a holistic approach, integrating social sciences into its methodologies and ideologies effectively.

Conclusion
Our study demonstrated a significant thematic shift in economic discussions within CLP following the 2017 name change, indicating a broader acknowledgment of its value to healthcare economics. While changes in other social science themes were not as pronounced, this consistency may reflect the field’s successful integration of a holistic perspective with medical and economic considerations, positioning CLP as a comprehensive, interdisciplinary field.

References
Boland, R. J., Rundell, J., Epstein, S., & Gitlin, D. (2018). Consultation-Liaison Psychiatry vs Psychosomatic Medicine: What's in a name?. Psychosomatics, 59(3), 207–210. https://doi.org/10.1016/j.psym.2017.11.006
Steuer, M. (2013). The Scientific Study of Society: Springer US.

Presentation Eligibility: Not previously presented or published

Diversity, Equity, and Inclusion: By understanding how CLP's involvement in the social sciences changes over time, we are also by extension tracking how the field's commitment to diversity changes over time. Our panel of authors includes those from a wide variety of ethnic, cultural, and socioeconomic backgrounds.