EPA-0956 - Psychiatric aspects of emergency medicine

Abstract

Objective The aim of the study was to investigate the development of the psychiatric emergency situation in the city of Ulm, Germany, over a decade ranging from 2004- 2013. Method All reports regarding medical emergencies in the city of Ulm (110,000 inhabitants) from 2004 to 2013 were examined. Psychiatric emergencies were identified and worked off retrospectively with respect of demographic variables, diagnosis, pharmacotherapy, general medical treatment and time trends. Results Data were available of 933 psychiatric emergency care episodes. 40% of episodes concerned male patients (60% female). Average age was 45.3 years. Diagnoses were made on a syndromal level on the basis of a classification by Hippius (Hippius H: Psychiatrie. Springer, Berlin, 1979). The most frequent syndromal diagnoses were 'state of psychomotor excitement', 'suicidal syndrome', 'syndrome of addictive behaviour' and 'acute intoxication'. These syndromal diagnoses occurred with increasing frequency later in the day. Medication interventions comprised mostly midazolame followed by haloperidol, diazepam and lorazepam. Conclusion The results of our study are roughly in line with those described in the literature based on studies dating back to the 1980s and 1990s. Emergency medicine is an multidisciplinary subject, in which psychiatric disorders account for a substantial proportion of episodes of care.