Clinical features in emergency psychiatric conditions

An epidemiological, retrospective, and analytical study was conducted to evaluate frequencies of emergency conditions, gender, age and demographical differentials, thus highlighting all clinical and demographical parameters relating to suicide attempts.

Two Hundred and Sixty Eight (268) patients hospitalized in the intensive care unit of the Department of Psychiatry at the Sarajevo University Medical Centre over the course of a one-year period (01.01.2004 - 31.12.2004) were examined and included in the study. Essentially, the symptoms were assessed via psychiatric examinations and through the medical history of the patients. The data collected by the study were analyzed statistically by using the SPSS and Chi Square test.

94% of all patients were hospitalized as being in an emergency situation, 6% were wrongly diagnosed and transferred into a relevant medical institution. 41% of patients were hospitalized at the point of crisis (with police and emergency medical staff), while the most frequent condition was exacerbation of schizophrenia (22.4%). Of the 94% of patients, 17.9% were suicide attempters, while the group at greatest risk was the youngest (18-24), although this group represents 4.5% of total. The other risk factors were male gender, age 30-49 years, single or divorced, and lower socioeconomic status. The most frequent means of attempted suicide was intoxication with medication. Nearly all the patients had made previous suicide attempts.

The study was conducted to provide an important epidemiological information on the characteristics of emergency admissions to psychiatric units and to underline the problem of triage and monitoring for this type of patients. How to prevent crises remains an open question; however this and other studies provide the necessary data to assist in managing and resolving this issue in the future.