title: [Classification of mental disorders in the Intensive Care Unit].
abstract: OBJECTIVE
  To determine the incidence and characteristics of mental disorders (MD) in the Intensive Care Unit (ICU), and to define a classification system adapted to the ICU environment.
  
  
  METHODS
  A retrospective, descriptive analysis.
  
  
  METHODS
  Intensive Care Unit, Arnau de Vilanova Hospital in Lérida (Spain).
  
  
  METHODS
  All patients with MD admitted during 5-year period (January, 1 2004 to December 31, 2008).
  
  
  METHODS
  General variables included clinical-demographic data, diagnostic variables, procedures, severity score, length of stay and mortality. Specific variables included psychiatric history, screening for substance abuse, psychiatric assessment, monitoring and transfer to a psychiatric center. Classification of the MD was as follows: 1) acute substance intoxication (SI); 2) suicide attempts (SA); and 3) MD associated with the main diagnosis (AMD).
  
  
  RESULTS
  A total of 146 patients had MD (7.8%); they were predominantly male (74%) and were younger than the general ICU population (43.9 vs. 55.3 years, p<0.001). The ICU stays of the patients with MDs were shorter (4 days vs. 7 days, p<0.001), and there was less hospital mortality (17.1 vs. 25%, p<0.05). They also showed a higher incidence of pneumonia (19.9 vs. 13.8%, p<0.05), but no differences in the level of severity were observed. The SI group (24.7%) contained the highest number of young people; the SA group (36.3%) showed a predominance of women; and the AMD (39%) group had the longest stays and the highest mortality. Psychiatric consultation was carried out mainly in the SA group (62.3%).
  
  
  CONCLUSIONS
  MD is a relatively common problem in the ICU. Collaboration with the Psychiatry Department seldom occurs, but must be encouraged to develop fully integrated management of critical patients with MD.
authors.affiliation: Servicio de Medicina Intensiva, Hospital Universitario Arnau de Vilanova, Lérida, España.
authors.forename: M
authors.initials: M
authors.lastname: Badia
authors.forename: M
authors.initials: M
authors.lastname: Justes
authors.forename: L
authors.initials: L
authors.lastname: Serviá
authors.forename: N
authors.initials: N
authors.lastname: Montserrat
authors.forename: J
authors.initials: J
authors.lastname: Vilanova
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez
authors.forename: J
authors.initials: J
authors.lastname: Trujillano
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology; D003953:Diagnosis-Related Groups; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000145:classification* / Q000453:epidemiology; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D011618:Psychotic Disorders / Q000453:epidemiology; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D013406:Suicide, Attempted / Q000706:statistics & numerical data