A comparison of aggression between patients with acute schizophrenia and mania presenting to psychiatric emergency services

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

Download Full-text

Characteristics of Children and Adolescents Receiving Psychiatric Emergency Services

PsycEXTRA Dataset ◽

10.1037/e522022008-001 ◽

2008 ◽

Author(s):

Jill R. McCulloch ◽

Emily Frosch ◽

Susan Dosreis

Keyword(s):

Children And Adolescents ◽

Emergency Services ◽

Psychiatric Emergency ◽

Psychiatric Emergency Services

Download Full-text

Impact of pharmacist driven medication reconciliation in psychiatric emergency services on length of stay, medication errors, and medication discrepancies

Drugs & Therapy Perspectives ◽

10.1007/s40267-021-00824-3 ◽

2021 ◽

Vol 37 (4) ◽

pp. 175-180

Author(s):

Megan O’Connell ◽

Amy VandenBerg

Keyword(s):

Length Of Stay ◽

Medication Errors ◽

Medication Reconciliation ◽

Emergency Services ◽

Psychiatric Emergency ◽

Psychiatric Emergency Services ◽

Medication Discrepancies

Download Full-text

Psychosocial Profiles of Patients Admitted to Psychiatric Emergency Services: Results from the Signature Biobank Project: Profils Psychosociaux de Patients Admis Dans des Services d’Urgence Psychiatrique : Résultats du Projet Banque Signature

The Canadian Journal of Psychiatry ◽

10.1177/07067437211018793 ◽

2021 ◽

pp. 070674372110187

Author(s):

Steve Geoffrion ◽

Kévin Nolet ◽

Charles-Édouard Giguère ◽

Tania Lecomte ◽

Stéphane Potvin ◽

...

Keyword(s):

Childhood Abuse ◽

Indirect Effect ◽

Structural Equation ◽

Emergency Services ◽

Psychiatric Patients ◽

Evaluation Process ◽

Psychiatric Emergency ◽

Psychotic Symptoms ◽

Psychiatric Emergency Services ◽

Targeted Interventions

Objectives: Patients admitted to psychiatric emergency services (PES) are highly heterogenous. New tools based on a transdiagnosis approach could help attending psychiatrists in their evaluation process and treatment planning. The goals of this study were to: (1) identify profiles of symptoms based on self-reported, dimensional outcomes in psychiatric patients upon their admission to PES, (2) link these profiles to developmental variables, that is, history of childhood abuse (CA) and trajectories of externalizing behaviours (EB), and (3) test whether this link between developmental variables and profiles was moderated by sex. Methods: In total, 402 patients were randomly selected from the Signature Biobank, a database of measures collected from patients admitted to the emergency of a psychiatric hospital. A comparison group of 92 healthy participants was also recruited from the community. Symptoms of anxiety, depression, alcohol and drug abuse, impulsivity, and psychosis as well as CA and EB were assessed using self-reported questionnaires. Symptom profiles were identified using cluster analysis. Prediction of profile membership by sex, CA, and EB was tested using structural equation modelling. Results: Among patients, four profiles were identified: (1) low level of symptoms on all outcomes, (2) high psychotic symptoms, (3) high anxio-depressive symptoms, and (4) elevated substance abuse and high levels of symptoms on all scales. An indirect effect of CA was found through EB trajectories: patients who experienced the most severe form of CA were more likely to develop chronic EB from childhood to adulthood, which in turn predicted membership to the most severe psychopathology profile. This indirect effect was not moderated by sex. Conclusion: Our results suggest that a transdiagnostic approach allows to highlight distinct clinical portraits of patients admitted to PES. Importantly, developmental factors were predictive of specific profiles. Such transdiagnostic approach is a first step towards precision medicine, which could lead to develop targeted interventions.

Download Full-text