title: Clinical characteristics of agitated psychotic patients treated with an oral antipsychotics attended in the emergency room setting: NATURA study.
abstract: Purpose. Prospective observational study to describe the clinical characteristics of patients with acute psychosis and agitation who receive oral psychopharmacological treatment at psychiatric emergency services (PES). Methods. A total of 278 patients with acute psychosis and agitation were admitted to PES and received oral psychopharmacological treatment. Diagnosis at admission, agitation level at entry and discharge, use of mechanical restraints, pharmacological and time to reintervention were prospectively explored. Severity of the disease was evaluated according to the Positive and Negative Syndrome Scale-Excitement Component (PANSS-EC), Agitation Calmness Evaluation Scale (ACES) and Clinical Global Impression-Severity (CGI-S) at admission, before first reintervention (if any) and at discharge from PES. Results. Most prevalent diagnoses were schizophrenia (77%) and bipolar disorder (12.2%). Mean (SD) scores in rating scales at baseline and at discharge were, respectively: PANSS-EC, 20.38(5.3) and 13.04 (5.5); CGI-S, 3.86(1.1) and 2.17(0.9); and ACES, 2.35(0.6) and 3.60(1.1). A total of 21.6% (60/278) of the patients required mechanical restraints and 38.1% (106/278) reintervention. From the emergency room, 20.5% patients went home while 71.2% were transferred to inpatient units. Conclusion. Clinical characteristics of psychotic agitated patients may help in deciding which type of treatment should be used and may be useful for the design of future prospective trials to explore treatment of agitation.
authors.affiliation: Lilly Research Laboratories, , Alcobendas, Spain.
authors.forename: Alonso
authors.initials: A
authors.lastname: Montoya
authors.forename: Luis
authors.initials: L
authors.lastname: San
authors.forename: José
authors.initials: J
authors.lastname: Manuel Olivares
authors.forename: Victor
authors.initials: V
authors.lastname: Pérez-Sola
authors.forename: Marta
authors.initials: M
authors.lastname: Casillas
authors.forename: Carmen
authors.initials: C
authors.lastname: López-Carrero
authors.forename: Pepa
authors.initials: P
authors.lastname: Polavieja
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Escobar
keywords: Agitation; emergency room; psychopharmacological treatment; psychosis; schizophrenia