title: [The patient in the psychiatric emergency ambulance: diagnoses, reasons and comparison of layperson vs. physician viewpoints].
abstract: A survey in specialties other than psychiatry showed that "emergency room"-patients have factors other than the presenting disease that determine the usage of urgent medical evaluation. In the following prospective study 104 outpatients presenting at daytime in a university psychiatric emergency care unit were included over 6 months. Apart from social and epidemiological data, illnesses according to ICD-10, reason for presentation from the patient's point of view and in this regard the physician's evaluation were included. The most prevalent diagnoses were depression, adjustment disorders and anxiety disorders, comprising together 75 %. Organic disorders or addictive disorders were less frequent; psychoses were found in 8 %. Concerning the presentation as an emergency, 70 % of patients reported a subjective clinical deterioration but only 44 % were regarded as an urgent need in the responsible physician's point of view (Cohen's kappa 0.39). Our findings show that patients presenting as "psychiatric emergency cases" without appointment mainly suffer from depression, adjustment disorders and panic disorders. Furthermore, the layperson's point of view of clinical deterioration justifying an emergency presentation differs from physician's evaluation. The most likely cause for this disagreement between physicians and patients in the assessment to utilise a medical emergency care service in psychiatry might be dysfunctional or, respectively, negative-biased cognitions accompanying depressive syndromes.
authors.affiliation: Psychiatrische und Psychotherapeutische Klinik, Universität Erlangen-Nürnberg, Erlangen.
authors.forename: F
authors.initials: F
authors.lastname: Quandt
authors.forename: S
authors.initials: S
authors.lastname: Wendel
authors.forename: U
authors.initials: U
authors.lastname: Degirmenci
authors.forename: S
authors.initials: S
authors.lastname: Kreil
authors.forename: K
authors.initials: K
authors.lastname: Bayerlein
authors.forename: A
authors.initials: A
authors.lastname: Rotter
authors.forename: J
authors.initials: J
authors.lastname: Kornhuber
authors.forename: M
authors.initials: M
authors.lastname: Weih
mesh_terms: D000275:Adjustment Disorders / Q000523:psychology / Q000628:therapy; D000328:Adult; D000368:Aged; D000552:Ambulances; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D001291:Attitude of Health Personnel; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D010361:Patients; D010820:Physicians; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy