Somatic Management of Psychiatric Patients in the Emergency Department

This retrospective study aims to assess a potential difference in the management of patients with a psychiatric history in somatic emergencies. Indeed, the psychiatric population has higher mortality and morbidity rates than the general population. The negative stigmatization of patients with mental health disorders remains one of the factors to consider when studying this morbidity and mortality. In this context, adult patients diagnosed with myocardial infarction, pulmonary embolism, stroke, acute cholecystitis or appendicitis in the emergency department of the Brugmann University Hospital Center during the year 2021 were selected. The presence or absence of a history psychiatric was then recorded for each patient. Different key intervention times, the total length of stay and the occurrence of complications were also studied for 459 patients, 74 of which had a history psychiatric. A significant difference in the time preceding the prescription of the first complementary examination for patients with a psychiatric history was thus highlighted. No other differences in care were demonstrated within the limits of this sample. This difference could be associated with the phenomenon of diagnostic overshadowing. It is the fact of associating the somatic complaints of a patient with his psychiatric pathology. Another potential explanation, present in the literature, could be the discomfort felt by somaticians when dealing with psychiatric patients. Finally, the integration of the experience of psychiatric patients into the training of physicians and the question of the relevance of applying the triage system to psychiatric patients were raised as potential future studies.