Characteristics of psychiatric emergencies and the choice of intervention strategies.
The aim of this study was to describe the sociodemographic, contextual and clinical characteristics of a consecutive sample of 3611 psychiatric emergency visits to a Swiss university general hospital, and to investigate their associations with different intervention strategies. All consultations were documented by a questionnaire covering sociodemographic and diagnostic data as well as information about the consultation and the disposition decision. In a total of 1093 cases (30.3%) no further emergency intervention was required, in 1287 cases (35.6%) patients were offered out-patient crisis intervention, and in 1231 cases (34.1%) patients were hospitalized. Social integration and the presence of an easily recognizable precipitating stressor were associated with referral to out-patient crisis intervention. In logistic regression analyses, referral by the police or by health professionals (in contrast to self-referral or referral by relatives), current diagnosis of a psychotic disorder, and previous hospitalizations were the most powerful predictors of hospitalization. The presence of a precipitating stressor related to the patient's social network decreased the likelihood of hospitalization. The findings indicate a need for facilities offering brief admission, allowing for extended emergency assessments.
Schnyder
U
U
Psychiatric Out-Patient Department, University Hospital, Zürich, Switzerland.
Klaghofer
R
R
Leuthold
A
A
Buddeberg
C
C
D000328:Adult; D000553:Ambulatory Care; D002755:Choice Behavior; D003419:Crisis Intervention; D004637:Emergency Services, Psychiatric; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013557:Switzerland