[Prescriptions in psychiatric emergencies].
The two missions of an emergency psychiatric intervention are firstly diagnostic, and then if possible, therapeutic. The therapeutic aims are thus dominated by two potential cases, one not exclusive of the other: hospitalisation and/or the obtainment of anxiolysis, if not sedation. In a psychiatric emergency, everything comes together in such a way that can induce serious errors, in terms of prescription, for the outcome for the patient: 1) not to appreciate the situation of the crisis, and above all, 2) to "over-estimate" the intensity of the problems, in confusing the gravity of the clinical picture with the intensity of the psychomotor agitation. A sedative and anxiolytic molecule proves to be necessary when faced with a patient in whom the agitation doesn't settle, who remains threatening and oppositional, or in whom the anxious character of the life-like delirium is manifest. Physical containment may be necessary and is then considered a prescribed therapeutic act that necessitates the surveillance of the subject. Therapeutic prescriptions are led by two cases which are not reciprocally exclusive non exclusive.
Vaiva
Guillaume
G
Clinique de psychiatrie et Centre d'accueil et de crise CHU de Lille & INSERM U513 Traitement des urgences 59037 Lille. gvaiva@chru-lille.fr
Ducrocq
François
F
Ezzedine
Mourad
M
D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D003693:Delirium; D004637:Emergency Services, Psychiatric; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D011595:Psychomotor Agitation / Q000188:drug therapy*; D012307:Risk Factors
D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives