title: [Necessity for treatment of psychiatric emergencies in the emergency medical service. Evaluation of the "indicator for psychiatric pharmacotherapy"].
abstract: BACKGROUND
  Psychiatric emergency situations (PES) are common in the physician-based emergency medical system (EMS) in Germany. However, many emergency physicians (EP) feel insecure in assessing the necessity for treatment of these patients. The aim of this investigation was to evaluate whether a short, newly developed questionnaire (Indicator for Psychiatric Pharmacotherapy, IPP) is able to help EPs in deciding for or against pharmacological treatment.
  
  
  METHODS
  The protocols of the EMS at the Saarland University Hospital were prospectively collected over a 1-year period and PESs were identified and analyzed in detail. The 7-item IPP, which focuses on the most relevant psychiatric symptoms, was to be completed for each PES.
  
  
  RESULTS
  Among all calls for an EP (2,114) 250 (11.8%) were classified as a PES. The most frequent diagnoses were alcoholic intoxication, state of agitation and suicide attempts. Of the IPP questionnaires 193 could be evaluated and in 31.2% of all PESs a specific psychiatric medication was administered. These patients scored significantly higher in the IPP compared to those who did not receive medication (8.0 ± 3.9 compared to 5.6 ± 3.2, p < 0.001). The IPP items "anxiety", "agitation/aggression", "mood" and "physical symptoms/disorders" had the highest impact on the administration of psychotherapeutic drugs.
  
  
  CONCLUSIONS
  The IPP can be a valuable tool to assess the necessity of pharmacological treatment for patients in PESs. The assessment of the symptom categories "anxiety", "agitation/aggression", "mood" and "physical symptoms/disorders" seems to be sufficient to estimate a need for treatment.
authors.affiliation: Klinik für Anästhesie und Intensivmedizin, Katholische Kliniken Essen-Nord-West gGmbH, Essen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Biedler
authors.forename: C
authors.initials: C
authors.lastname: Helfen
authors.forename: F-G B
authors.initials: FG
authors.lastname: Pajonk
mesh_terms: D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000628:therapy; D001007:Anxiety / Q000175:diagnosis; D004632:Emergency Medical Services / Q000379:methods* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D010820:Physicians; D011595:Psychomotor Agitation / Q000188:drug therapy; D011619:Psychotropic Drugs / Q000627:therapeutic use; D011785:Quality Assurance, Health Care; D013406:Suicide, Attempted; D011795:Surveys and Questionnaires
chemical_list: D011619:Psychotropic Drugs