[Efficacy of the emergency unit's filter function in patients with psychiatric symptoms]

The fundamental functions of the recently established emergency units/departments include the initial assessment, triage, commencement of treatment and referral for admission to the hospital.

The aim of the study was to analyze psychiatric cases assessed at the department of emergency with particular reference to misdiagnoses and the reasons why emergency physicians failed to reach correct diagnoses.

This is a chart review of patients with psychiatric diagnoses evaluated at the Department of Emergency, Mohács City Hospital during 2006. These patients were followed through the electronic database of the hospital and their socio-demographic and clinical characteristics were analyzed.

Of the 596 patients who were considered primarily psychiatric cases during 2006, 289 (49%) were admitted to the psychiatric ward, 182 (30%) were referred to outpatient treatment, and 125 (21%) were misdiagnosed and proved to be non-psychiatric emergencies and eventually ended up in other wards (75 patients in internal medicine, 20 in neurology, 12 in intensive care, and 18 in other units).

Overall, the diagnostic and triage functions of the department of emergency were satisfactory in psychiatric cases. Medical emergencies that were frequently mistaken for psychiatric cases (e.g. atypical pneumonia, sensory aphasia) deserve particular attention. The authors emphasize the importance of the close collaboration of different medical areas involved in emergency assessment and treatment.