Aggressivity and Atmosphere in a General Hospital Psychiatric Emergency Service

This research identifies possible indicators of risk of aggressivity in a general hospital psychiatric ward going beyond the analysis of the episode in itself. We suggest that behaviour can be strongly conditioned by the milieu (which is organised in a similar way to other hospital wards) especially since we have found that violence is not correlated with diagnosis. We have used the Overt Aggressivity Scale and our own Ward Atmosphere Evaluation Scale (currently under validation) in order to identify those features which increase or reduce the risk of violent episodes. Factorial analysis and the study of risk probability have enabled us to create a 12 point scale (from red alert to yellow calm) of the probability/possibility of violent episodes. the scale allows psychiatric staff to assess the risk of aggressivity and consequently to modify the management and organisation of the ward if necessary (including emotional and psychological attitudes of the staff).

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Outreach Psychiatric Emergency Service

Crisis ◽

10.1027/0227-5910/a000651 ◽

2020 ◽

Vol 41 (5) ◽

pp. 375-382

Author(s):

Remco F. P. de Winter ◽

Mirjam C. Hazewinkel ◽

Roland van de Sande ◽

Derek P. de Beurs ◽

Marieke H. de Groot

Keyword(s):

General Practitioner ◽

General Hospital ◽

Suicidal Behavior ◽

Emergency Service ◽

Attempted Suicide ◽

Emergency Services ◽

Psychiatric Emergency ◽

Psychiatric Emergency Services ◽

Psychiatric Emergency Service ◽

Suicidal Patients

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.

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Repeated users of a psychiatric emergency service in a Canadian general hospital

Psychiatric Quarterly ◽

10.1007/bf01064733 ◽

1986 ◽

Vol 58 (3) ◽

pp. 189-201 ◽

Cited By ~ 11

Author(s):

Edgardo P�rez ◽

Alberto Minoletti ◽

Jane Blouin ◽

Arthur Blouin

Keyword(s):

General Hospital ◽

Emergency Service ◽

Psychiatric Emergency ◽

Psychiatric Emergency Service

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A retrospective study of adolescents' visits to a general hospital psychiatric emergency service

American Journal of Psychiatry ◽

10.1176/ajp.144.4.432 ◽

1987 ◽

Vol 144 (4) ◽

pp. 432-436 ◽

Cited By ~ 19

Keyword(s):

Retrospective Study ◽

General Hospital ◽

Emergency Service ◽

Psychiatric Emergency ◽

Psychiatric Emergency Service

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Assessment of suicide attempts in an emergency service of a General Hospital

European Psychiatry ◽

10.1016/s0924-9338(11)73339-9 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1635-1635

Author(s):

M. Pérez García ◽

B. Portela Traba ◽

A. Mozos Ansorena ◽

J.M. Cornes Iglesias ◽

M. Páramo Fernandez

Keyword(s):

Emergency Department ◽

Suicide Attempt ◽

Drug Overdose ◽

Emergency Service ◽

Suicide Attempts ◽

Psychiatric Emergency ◽

Psychiatric Ward ◽

Psychiatric Emergency Service ◽

Icd 10 ◽

History Of

IntroductionThere is a high frequency of attendance at emergency medical service for suicide attempts.ObjectivesDetermine the type of urgency for suicide attempt in our country.Material and methodsThe present study treats of suicide attempts (n = 248) attended by the Psychiatric Emergency Service of Hospital in our city between 2004–2008. The diagnoses were made by clinical interview following ICD-10 criteria.Results248 suicide attempts (60% women), with age between 15 and 88 years.There are equal proportions of singles and married (a 38%). 53% live with couple with/without children, 30%live with parents and a 10%live alone. >55% of patients have a middle education and socioeconomic level. The average time from suicide attempt until the assessment in the emergency department is 2.71 ± 3.64 hours. The day of the week with more assistance for this reason is Monday. Also it's observed an increase in the months between May and October. The cases are uniformly distributed throughout the month, although there is a decrease in the number of cases in the initial and final days of the month. 60% of patients haven’t history of previous attempts and use an only method that is drug overdose. Personality disorders are the most frequent diagnose and 44% patients need an internment in a psychiatric ward.ConclusionsProfile of the patient who makes a suicide attempt and that is evaluated in the Psychiatric Emergency Service of our Hospital: woman 36 years old, married/with couple and lives with him/her. She comes to emergency department in the first 4 hours after the drug overdose. She hasn’t history of previous attempts.She is diagnosed of emotionally unstable personality disorder.

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