Consultation-Liaison Psychiatry: Predictors of hospitalization, rapid tranquilization and consultation appropriateness

Psychiatric emergencies represent a substantial challenge within general hospital settings, requiring effective integration between emergency medicine and Consultation-Liaison Psychiatry. This retrospective observational study investigated the clinical characteristics, determinants of hospitalization, predictors of rapid tranquillisation, and appropriateness of psychiatric consultations performed at the Consultation-Liaison Psychiatry Service of the University Psychiatric Unit, in Foggia, Italy. A total of 447 consecutive psychiatric consultations conducted between January and December 2025 were considered. Most consultations were requested from the Emergency Department (85.9%), with psychomotor agitation representing the leading reason for referral (46.5%). Most patients had a previous psychiatric history (over 70%), while depressive disorders were the most frequent diagnoses. Rapid tranquillisation was required in 61.2% of consultations, predominantly using benzodiazepines. Psychiatric hospitalization occurred in 20.2% of cases, whereas 89.0% of consultations were considered appropriate. Hospitalization was independently predicted by psychotic symptoms (AOR = 3.6), previous contact with Community Mental Health Services (AOR = 2.2), as well as previous psychiatric history (AOR = 1.8). Rapid tranquillisation was strongly associated with psychomotor agitation (AOR = 8.5), red triage classification (AOR = 3.9), psychosis (AOR = 2.4), and substance-related presentations (AOR = 2.1). Appropriate consultations were independently associated with high-acuity triage codes, agitation, and psychosis. These findings highlight that structured triage systems and consultation-liaison models facilitate appropriate resource allocation and clinical decision-making.