FACTORS RELATED TO ADMISSION OF PSYCHIATRIC PATIENTS TO MEDICAL WARDS FROM THE GENERAL HOSPITAL EMERGENCY DEPARTMENT: A 3-YEAR STUDY OF URGENT PSYCHIATRIC CONSULTATIONS
FACTORS RELATED TO ADMISSION OF PSYCHIATRIC PATIENTS TO MEDICAL WARDS FROM THE GENERAL HOSPITAL EMERGENCY DEPARTMENT: A 3-YEAR STUDY OF URGENT PSYCHIATRIC CONSULTATIONS
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DOI：
10.2190/pm.39.2.b
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发表时间：
2009-01-01
影响因子：
2
通讯作者：
Grassi, Luigi
中科院分区：
文献类型：
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作者：
Biancosino, Bruno;Vanni, Adello;Grassi, Luigi
目的：综合性医院急诊科（艾德）急诊室（ER）在提供精神病评估方面具有重要作用。本研究的目的是检查的决策过程中的咨询精神病学在GH-ER和精神病患者之间的差异进行分析，承认的医疗病房与精神科病房和那些谁是从急诊室出院。方法：在3年的时间内，精神科咨询要求ER的艾德医生GH精神病服务记录使用一种形式来描述流行病学和临床数据的咨询过程。结果如下：在1，962次精神科咨询中，大多数咨询对象以前曾与精神科接触（76.2%），至少有一次精神科住院（53.6%），目前由精神卫生机构照顾（51.1%）。神经症/应激相关综合征（27.98%）、精神分裂症（27.67%）和人格障碍（21.81%）是最常见的ICD-10诊断。在49.9%的病例中，精神科医生的处置是让患者出院，将其送入总医院内科病房（MGH; 26.9%）或急性住院精神病病房（AIP; 23.1%）。MGH组与AIP组的女性差异有统计学意义（p < 0.01），老年人（p < 0.01），更可能具有神经症/应激相关综合征的ICD-10诊断（P < 0.01）或器质性精神障碍（p < 0.01），并且不太可能被诊断为精神分裂症（p < 0.01）、负责精神卫生服务（p < 0.01）和以前有精神病住院史（p < 0.01）。Logistic回归分析证实了这些结果。结论：研究表明，综合医院的内科病房是为患有ICD-10神经症和应激相关综合征的患者提供精神病护理的重要切入点，即使没有具体的医疗问题。(Int我。J. Psychiatry in Medicine 2009;39：133-146）
Objective: Emergency Rooms (ER) of Emergency Departments (ED) in General Hospitals (GH) have a 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-ER 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 ER. Method: Over a period of 3 years, psychiatric consultations requested by ER of ED physicians to the GH Psychiatric service were recorded by using a form to describe epidemiological and clinical data on the consultation process. Results: Of 1,962 psychiatric 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 Set-vices (51.1%). Neurotic/stress-related syndromes (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 GH (MGH; 26.9%) or to the acute inpatient psychiatric ward (AIP; 23.1%). MGH group statistically differed from AIP group for being female (p < 0.01), older (p < 0.01), more likely having an ICD-10 diagnosis of neurosis/stress-related syndromes (p < 0.01) or organic mental disorder (p < 0.01), and less likely having a diagnosis of 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 neurotic and stress-related syndromes, even if without specific medical problems. (Int'l. J. Psychiatry in Medicine 2009;39:133-146)