[Psychiatric consultation and liaison sevices in the emergency department]

In somatic emergency departments, the prevalence of psychiatric emergencies is high, ranging from 5-10%. The psychiatric consultation and liaison service plays a central role in the interdisciplinary care of emergency patients in somatic emergency departments. It addresses patients primarily with psychiatric disorders, organically caused psychiatric conditions and somatic illnesses with psychiatric comorbidities. While consultation activities involve advising other medical disciplines, consultation and liaison services enable continuous treatment of patients. Depending on the organization as a consultation or combined consultation and liaison service, the aim is to ensure efficient, targeted, safe and cost-effective evaluation of psychiatric symptoms and/or to screen as many patients as possible with psychiatric symptoms, facilitating access to psychiatric treatment. Psychiatric consultation and liaison services can furthermore support decisions regarding necessary somatic evaluations prior to psychiatric treatment. The "SMART medical clearance form" provides a standardized approach to somatic evaluations for patients with psychiatric symptoms in emergency departments. To improve psychiatric assessments of patients in somatic emergency departments, further standardization of the recommended somatic examinations and the evaluation of whether somatic symptoms can be associated with an underlying psychiatric disorder are needed. In addition, guidelines should establish which patients require a psychiatric consultation assessment in emergency departments.