[Psychiatric emergency consultation in a general hospital]

Inpatients in general hospital often presented with psychological problems and some of them need emergent psychiatric interventions. However, there have been little attention on the psychiatric emergency consultation. The purpose of this paper is to review the psychiatric emergency service in a general hospital over 3-year period. During this period, there were 88 psychiatric emergency consultations that represented 2.3% of all psychiatric consultations. The emergency group showed no difference in sex and age, but received more diagnoses of delirium (58.0%) than the other referrals. About one fourth of these patients had psychiatric history. Stated requests for "agitation and irritability", "psychiatric symptoms" and "uncooperation with treatment" were the most frequent reasons. Sixty-five percent of the patients receive recommendations of medication treatment. Among them, neuroleptics and anxiolytics were most common used. About one half of the patients needed further medical tests. After psychiatric interventions, most of the patients got improved within 2 days but 15 patients died during hospitalization. These findings indicated that psychiatric emergency consultation though the request rate is low. When making diagnoses in emergency consultation, past psychiatric history is important and organic mental disorders should be ruled out first. After psychiatric interventions, most of the psychiatric emergency could be improved. It suggested that the setting of psychiatric emergency consultation could improve the quality of patient care in a ageneral hospital.