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The paper reports a descriptive survey of the referrals received by a new psychiatric liaison service in Rawalpindi in the first 2 years. The survey showed a rapid increase in use of the service, particularly by the emergency department. There was a lower proportion of referrals for self-harm and substance misuse than occurs in similar services in high-income countries but a higher proportion of patients presenting with dissociative (conversion) disorders. The large proportion of patients who had abnormal findings on physical examination remains unexplained and warrants further investigation.