title: The management of psychiatric emergencies.
abstract: BACKGROUND
  Psychiatric emergencies such as acute psychomotor agitation or suicidality often arise in non-psychiatric settings such as general hospitals, emergency services, or doctors' offices and give rise to stress for all persons involved. They may be life-threatening and must therefore be treated at once. In this article, we discuss the main presenting features, differential diagnoses, and treatment options for the main types of psychiatric emergency, as an aid to their rapid and effective management.
  
  
  METHODS
  Selective literature review.
  
  
  CONCLUSIONS
  The frequency of psychiatric emergencies in non-psychiatric settings, such as general hospitals and doctors' offices, and their treatment are poorly documented by the few controlled studies and sparse reliable data that are now available. The existing evidence suggests that the diagnosis and treatment of psychiatric emergencies need improvement. The treatment of such cases places high demands on the physician's personality and conduct, aside from requiring relevant medical expertise. Essential components of successful treatment include the establishment of a stable, trusting relationship with the patient and the ability to "talk down" agitated patients calmly and patiently. A rapid and unambiguous decision about treatment, including consideration of the available options for effective pharmacotherapy, usually swiftly improves the acute manifestations.
authors.affiliation: Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Mavrogiorgou
authors.forename: Martin
authors.initials: M
authors.lastname: Brüne
authors.forename: Georg
authors.initials: G
authors.lastname: Juckel
mesh_terms: D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence; D003299:Cooperative Behavior; D003617:Dangerous Behavior; D003937:Diagnosis, Differential; D004630:Emergencies; D004637:Emergency Services, Psychiatric; D006801:Humans; D033183:Interdisciplinary Communication; D007872:Legal Guardians / Q000331:legislation & jurisprudence; D016743:Mental Competency / Q000331:legislation & jurisprudence; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010817:Physician-Patient Relations; D011595:Psychomotor Agitation / Q000628:therapy; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012017:Referral and Consultation; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D013405:Suicide / Q000523:psychology; D000092864:Suicide Prevention
chemical_list: D011619:Psychotropic Drugs