title: Clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder in a psychiatric emergency service.
abstract: BACKGROUND
  To analyze factors associated with clinical observation, pharmacotherapy and referral on discharge of patients with anxiety disorder (AD) seeking care at a psychiatric emergency unit.
  
  
  METHODS
  A total of 5003 consecutive visits were reviewed over a three-year period at a psychiatric emergency service in a tertiary university hospital. Data collected included sociodemographic and clinical information as well as the Global Assessment of Functioning (GAF) and the Severity Psychiatric Illness (SPI) scale scores.
  
  
  RESULTS
  Of all the visits, 992 (19.8%) were diagnosed of AD. Of these, 19.6% required clinical observation and 72.2% were referred to a psychiatrist at discharge. Regression analysis showed that referral to psychiatry was associated with being male, native, psychiatric background, greater severity, lower global functioning, and behavioral disorders. Clinical observation (in a box) was associated with being female, greater severity, and psychotic or behavioral symptoms. Prescription of benzodiazepines was associated with anxiety, no history of addiction, and lower global functioning. Antidepressants were associated with being a native, anxiety with no history of addiction, and lower functioning. Antipsychotics were associated with being native, psychiatric background (not addiction), anxiety, and lower functioning.
  
  
  CONCLUSIONS
  Behavior, psychiatric background and illness severity were determinants of referral to a specialist. Besides these, psychotic symptoms and non-specific clinical symptoms were determinants of observation. Drug prescription in AD is less frequent if the main complaint is not anxiety and depends more on the level of functioning than on that of severity.
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: Guillem
authors: G
authors: Pailhez
authors: Centre de Salut Mental Badalona 2 &#8211; Institut Municipal Serveis Personals. Badalona.
authors: Albert
authors: A
authors: Majó
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: David
authors: D
authors: Córcoles
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: José M
authors: JM
authors: Ginés
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: José M
authors: JM
authors: Arcega
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: Juan
authors: J
authors: Castaño
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: Ana
authors: A
authors: Merino
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: Antonio
authors: A
authors: Bulbena
authors: Institut de Neuropsiquaitria i Addiccions &#8211; Hospital del Mar. Barcelona.
authors: Víctor
authors: V
authors: Pérez
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000188:drug therapy*; D004637:Emergency Services, Psychiatric; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012017:Referral and Consultation