Inpatient Rehabilitation Psychiatry: A Literature Review and Illustrative Case Series
Bibliographic record
Abstract
Introduction Physical rehabilitation is usually required after serious illness or injury; there is a significant need for simultaneous psychiatric rehabilitation as well. Psychiatric consultation to inpatient rehabilitation units presents with unique clinical questions distinct from consultation to other units. Objectives To present a literature review and an illustrative case series of common psychiatric referrals from physical rehabilitation units. Methods First, the current literature was reviewed on PubMed looking at current models of psychiatric consultation to inpatient physical medicine and rehabilitation units. Second, cases were reviewed from tertiary post-acute care units including stroke, acquired brain injury, post-fracture fast and slow stream, and complex continuing care. Third, thematic analysis was performed to extract illustrative themes presented in a case series of four mock patients. Results There is a paucity of literature on psychiatric consultation to inpatient physical rehabilitation units. The current literature, however, supports high utilization of psychiatric consultation in comorbid physical illness (Daly et al 2023, PMR). Four major themes emerged on psychiatric consultation to inpatient physical rehabilitation: (1) Interdisciplinary management of basophobia [the fear of falling], (2) Managing severe persisting mental illness and addressing medications that increase the risk of falling, (3) Managing new onset trauma-related disorders and pain-related disorders, (4) Assessing partial cognitive improvement and impairment in the setting of brain injury. Conclusions Psychiatrists often deal with patients recovering from an episode of serious physical illness or injury. There is significant overlap between the work done in physical and psychiatric rehabilitation. Patient and staff education, judicious prescribing and de-prescribing, and interdisciplinary management are critical to successful outcomes. Disclosure of Interest None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".