Objective - Emergency Department (ED) in General Hospitals has a significant role in providing for psychiatric evaluation. The aims of the present study were to examine the decision-making process of consultation psychiatry at the GH-ED and to analyze the differences between psychiatric patients admitted to a medical ward with those admitted to the psychiatry unit and those who are discharged from the ED. Method - Psychiatric consultations requested by ED physicians over a period of three years were recorded by using a form to describe epidemiological and clinical data on the consultation. Results - Of 1,962 consultations, most regarded subjects who had had previous psychiatric contacts (76.2%) and at least one psychiatric admission (53.6%), and were currently cared for by the Mental Health Services (51.1%). Neurotic disorders (27.98%), schizophrenia (27.67%), and personality disorders (21.81%) were the most frequent ICD-10 diagnoses. The psychiatrist’s disposal was to discharge the patient in 49.9% cases, to admit him/her to medical wards of the General Hospital (26.9%) (GH) or to the Acute Inpatient Psychiatric Unit (23.1%) (AIPU). GH group statistically differed from AIPU group for being female (p<0.01), older (p < 0.01), having an ICD-10 diagnosis of neurosis and related syndromes (p<0.01) or organic mental disorder (p<0.01), and less likely having a diagnosis f schizophrenia (p<0.01), being in charge of the Mental Health Services (p<0.01) and having had previous psychiatric admissions (p <0.01). These results were confirmed by logistic regression analysis. Conclusions - The study shows that the medical wards of the General Hospital are a significant entry-point for providing psychiatric care of patients with ICD-10 organic mental syndromes and neurotic and stress-related syndromes.
Factors related to admission of psychiatric patients to medical wards from the General Hospital Emergency Department: A 3-year study of urgent psychiatric consultations
BIANCOSINO, Bruno;MARMAI, Luciana;ZOTOS, Spyridon;VANNI, Adello;MAGRI, Vanessa;GRASSI, Luigi
2009
Abstract
Objective - Emergency Department (ED) in General Hospitals has a significant role in providing for psychiatric evaluation. The aims of the present study were to examine the decision-making process of consultation psychiatry at the GH-ED and to analyze the differences between psychiatric patients admitted to a medical ward with those admitted to the psychiatry unit and those who are discharged from the ED. Method - Psychiatric consultations requested by ED physicians over a period of three years were recorded by using a form to describe epidemiological and clinical data on the consultation. Results - Of 1,962 consultations, most regarded subjects who had had previous psychiatric contacts (76.2%) and at least one psychiatric admission (53.6%), and were currently cared for by the Mental Health Services (51.1%). Neurotic disorders (27.98%), schizophrenia (27.67%), and personality disorders (21.81%) were the most frequent ICD-10 diagnoses. The psychiatrist’s disposal was to discharge the patient in 49.9% cases, to admit him/her to medical wards of the General Hospital (26.9%) (GH) or to the Acute Inpatient Psychiatric Unit (23.1%) (AIPU). GH group statistically differed from AIPU group for being female (p<0.01), older (p < 0.01), having an ICD-10 diagnosis of neurosis and related syndromes (p<0.01) or organic mental disorder (p<0.01), and less likely having a diagnosis f schizophrenia (p<0.01), being in charge of the Mental Health Services (p<0.01) and having had previous psychiatric admissions (p <0.01). These results were confirmed by logistic regression analysis. Conclusions - The study shows that the medical wards of the General Hospital are a significant entry-point for providing psychiatric care of patients with ICD-10 organic mental syndromes and neurotic and stress-related syndromes.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
