Five-Year Outcomes Following Psychiatric Consultation to a Tertiary Care Emergency Room

Lambert, Monique; LePage, James P.; Schmitt, Andrew L.

doi:10.1176/appi.ajp.160.7.1350

Cited by 27 publications

(27 citation statements)

References 9 publications

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“…23 The rate of referrals to psychiatric hospitalization (8.2%) was lower than reported in other Brazilian studies and internationally. 12,15,18 This finding probably reflects the characteristics of the population, as well as the care network available in the city.…”

Section: Discussionmentioning

confidence: 86%

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Profile of patients attended as psychiatric emergencies at a university general hospital

et al. 2013

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CONTEXT AND OBJECTIVE: The prevalence of psychiatric conditions in clinical settings is high, particularly in emergency services. This is a challenge for healthcare professionals and an essential element in the functioning of the mental health network. The objective here was to describe the sociodemographic and clinical profile and the practices among patients treated psychiatrically in the Emergency Unit. DESIGN AND SETTING: Descriptive and quantitative study, conducted at Hospital das Clínicas (HC), Universidade Estadual de Campinas (Unicamp). METHODS: Sociodemographic data, reasons for attendance, diagnostic hypotheses and practices were analyzed. RESULTS: Psychiatric staff attended 1,835 cases over the study period, corresponding to 1465 patients. The patients were predominantly women (53.7%) and white (79.6%); their mean age was 37 years and 41.3% lived with their parents. The commonest reasons for attendance were depressive symptoms (28.1%), agitation (23.6%) and problems with psychoactive substances (19.5%). The commonest diagnoses were psychoactive substance-related disorders (23%) and depressive disorders (18.5%). 31.6% of the patients were referred to healthcare centers and 29.2% to specialized outpatient clinics, while 8.2% were hospitalized. CONCLUSIONS: This study emphasizes that it is important for professionals working in emergency service to have information about the patients' profile and the main reasons that lead them to seek psychiatric care, and to establish a diagnosis that will allow proper management at the emergency service and case referral. RESUMO CONTEXTO E OBJETIVO:A prevalência de quadros psiquiátricos em contextos clínicos é elevada, particularmente em serviços de emergência, representando um desafio para os profissionais da saúde e um elemento essencial no funcionamento da rede de saúde mental. Objetivou-se descrever o perfil sócio-demográfico, clínico e condutas para pacientes atendidos pela psiquiatria na Unidade de Emergência.

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Section: Discussionmentioning

confidence: 86%

“…This difficulty has also been observed in other studies conducted in emergency services. 18,24,25 This problem limits data gathering, thus resulting in high rates of missing data and hindering descriptive analyses and establishment of correlations.…”

Section: Discussionmentioning

confidence: 99%

Profile of patients attended as psychiatric emergencies at a university general hospital

et al. 2013

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“…This is reflected by their high admission rates (22% to 35% 2,8,[13][14][15] ; and up to 54% for patients with substance abuse). 15 This high admission rate, combined with a lack of acute care beds on inpatient psychiatric units 1-3,10,11 results in boarding of admitted patients in ED corridors.…”

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confidence: 99%

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

et al. 2015

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Objective: To describe the characteristics and needs prior to, on admission, during the first month in hospital, at the thirtieth day of hospitalization and posthospital discharge of psychiatric patients occupying acute beds.Methods: This prospective observational study was conducted in 2 tertiary care hospitals. Adult patients hospitalized on a psychiatric unit for 30 days were identified. Data was collected from their medical charts and interviews with their health care team. The categorization of acute and nonacute status at day 30 was based on the health care professional's evaluation. Descriptive and univariate analyses were performed.Results: A total of 262 patients were identified (mean age 45 years), 66% lived at home and 11% were homeless. More than one-half were cognitively impaired and a few had special medical needs. Ninety-seven per cent had been admitted from the emergency department. At day 30, 81% of patients required acute care, while 19% (95% CI 15% to 24%) occupied an acute care bed, despite the resolution of their acute condition. The main reason preventing discharge of nonacute patients was the difficulty or inability to find appropriate resources that met patients' needs. As for patients who required acute care, the most common psychiatric issues were delusions or hallucinations (34%), inability to take medications independently (23.6%), and inadequate control of aggression or impulsivity (16.5%). Conclusions:Prevention of the discharge of nonacute patients is largely due to the difficulty in finding appropriate resources that meet patients' needs. Improved access to community and subacute care resources could potentially facilitate the hospital discharge of psychiatric nonacute patients. W W W Caractéristiques et besoins des patients psychiatriques dont le séjour à l'hôpital est prolongéObjectif : Décrire les caractéristiques et les besoins, avant l'hospitalisation, au moment de l'admission, durant le premier mois, au 30 e jour d'hospitalisation et après le congé de l'hôpital de patients psychiatriques occupant des lits de soins actifs.Méthode : Cette étude d'observation prospective a été menée dans 2 hôpitaux de soins tertiaires. Les patients adultes hospitalisés dans une unité psychiatrique pendant 30 jours ont été identifiés. Les données ont été recueillies dans leurs dossiers médicaux et par des entrevues avec leur équipe de soins de santé. La catégorisation du statut aigu et non aigu au 30 e jour se fondait sur l'évaluation des professionnels de la santé. Des analyses descriptives et univariées ont été exécutées.Résultats : Un total de 262 patients ont été identifiés (âge moyen 45 ans), dont 66 % vivaient à la maison et 11 % étaient sans abri. Plus de la moitié étaient cognitivement déficients et quelques-uns avaient des besoins médicaux spéciaux. Quatre-vingt

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“…This difficulty was also observed in other studies made in emergency services. 9 This problem limits the data collection, resulting in high rates of missing data and hindering the descriptive analyzes and the establishment of correlations.…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…8 A prospective study conducted in a tertiary Emergency Room Unit in Canada showed that 59% of patients who had been treated by the psychiatric team were diagnosed with primary or secondary substance dependence. 9 North American data indicate that there is an increasing tendency in emergency admissions at the Emergency Rooms due to PAS related-disorders, being more significant in relation to illicit substances. 10 Patients with PAS use disorders, when compared to patients who seek Emergency Rooms for other reasons, are younger.…”

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confidence: 99%

Patients with psychoactive substance use disorders treated in a psychiatric emergency unit

Padilha

Santos-Júnior

Schettini

et al. 2016

Medicina (Ribeirão Preto)

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Modelo do Estudo: Estudo de prevalência. Objetivo: Descrever o perfil sócio demográfico e clínico de pacientes com transtornos relacionados ao uso de substâncias psicoativas (SPA) atendidos pela Psiquiatria da Unidade de Emergência Referenciada (UER) do Hospital de Clínicas (HC) da UNICAMP. Métodos e casuística: Estudo descritivo e quantitativo, que avaliou os pacientes com transtornos relacionados ao uso de SPA atendidos pela Psiquiatria da UER do HC-UNICAMP no período de 12 meses a partir de maio de 2010. Resultados: Foram avaliados 350 pacientes com transtornos por uso de SPA, representando 23.8% do total dos que procuraram atendimento psiquiátrico. Maioria do sexo masculino e mais jovens do que os demais pacientes. O principal motivo de atendimento foi queixa psiquiátrica outra que não o uso de SPA (23,1%), seguido do desejo de se tratar/internar (20,8%) e intoxicação (12,5%). 38,5% tinham diagnóstico de dependência de múltiplas SPA e 34,8% dependência exclusiva de álcool; 36% apresentavam comorbidade psiquiátrica. Quando comparados com os demais pacientes avaliados pela Psiquiatria, receberam mais medicações no atendimento e foram menos encaminhados à atenção primária. Conclusão: Há elevada taxa de atendimento de pessoas com problemas relacionados ao uso de SPA na emergência psiquiátrica. Dados sobre o perfil dos atendidos podem contribuir para a melhoria da assistência a esta população

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Five-Year Outcomes Following Psychiatric Consultation to a Tertiary Care Emergency Room

Abstract: These findings reveal relationships between diagnostic profiles and future psychiatric hospitalization and mortality rates. This information could focus psychiatric and medical interventions for high-risk patients.

Cited by 27 publications

References 9 publications

Profile of patients attended as psychiatric emergencies at a university general hospital

Profile of patients attended as psychiatric emergencies at a university general hospital

Characteristics and Needs of Psychiatric Patients with Prolonged Hospital Stay

Patients with psychoactive substance use disorders treated in a psychiatric emergency unit

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