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Psychiatric emergencies in the elderly population.
1Division of Psychiatry, Boston University School of Medicine, Robinson Building B-410, 88 East Newton Street, Boston, MA 02118, USA. joanna.buczek@bmc.org
Emergency Medicine Clinics of North America
|April 6, 2006
Summary
Geriatric behavioral emergencies, including psychosis and depression, are common in emergency departments. Effective management requires ruling out organic causes and interdisciplinary collaboration for optimal patient outcomes.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Psychiatry
Background:
- Behavioral emergencies are frequently encountered by emergency physicians in geriatric patients.
- These emergencies encompass conditions such as psychosis, severe depression, agitation, suicidal ideation, and substance abuse.
Purpose of the Study:
- To review common behavioral emergencies in the geriatric population.
- To highlight challenges in assessing and managing these conditions in the emergency department.
Main Methods:
- Review of common behavioral emergencies in geriatric patients.
- Discussion of assessment complexities, including ruling out organic causes and patient history limitations.
- Emphasis on the need for expertise in geriatric emergency care.
Main Results:
- Evaluation is complicated by the need to assess medical, psychiatric, substance abuse, and psychosocial factors.
- Cognitive impairment or acute distress can limit patient recall of history.
- Inadequate expertise among emergency department personnel can impede appropriate management.
Conclusions:
- Ruling out organic causes is critical when assessing apparent psychiatric disease in the elderly.
- Collaboration between emergency departments, primary care, psychiatric consultants, and social services is essential.
- High-quality emergency care and integrated services are crucial for optimal outcomes in geriatric psychiatric decompensation.