Who is seeking Emergency Care at the Emergency Psychiatric Ward of Bakirkoy Mental Health and Neurological Diseases Education and Research Hospital? A cross-sectional definitive study

Küçükali, Çiğdem; Güveneroğlu, Neşe Üstün; Duman, Hakan; Eradamlar, Nezih; Alpkan, Latif

doi:10.5455/apd.178894

Cited by 3 publications

(1 citation statement)

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“… 20 The distribution of diagnoses is also similar to another study from a mental hospital in Istanbul, with a lower rate of emergency hospitalizations at our hospital. 21 A study from another training hospital in Turkey has also found no significant difference with regard to the working hours, 3 which might be related to the general lower rate of admissions during night shifts. Yet, findings from other studies indicate that restraint measures are more often resorted to during night shifts.…”

Section: Discussionmentioning

confidence: 95%

Physical Restraint Practices at the Emergency Department of a Mental Health Hospital

Güngör,

Poyraz,

Melenkiş

et al. 2024

Psychiatry and Clinical Psychopharmacology

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Background: Coercive treatments can lead to ethical, legal, and clinical concerns, especially in emergency settings. The indications and characteristics of patients for whom physical restraint is indicated should be well-evaluated in order to prevent unnecessary practices. The aim of this study was to comprehensively assess the physical restraint practices in psychiatric emergencies and clinical characteristics related to their use. Methods: All patients admitted to the emergency unit of a tertiary mental health hospital between June 1 and June 30, 2022, were included in the sample. Data were retrieved from the manual and electronic medical records. Age, gender, clinical settings, diagnosis, substance use, and other factors were categorized and analyzed, comparing physically restrained and not-restrained patients. Results: Totally, 2051 patients were included in the study (1022 female and 1029 male). The mean age of the participants was 39.5 ± 14.8 years (female: 40.3 ± 14.8 male: 38.4 ± 14.7, P = .004). Seventy-two (3.51%) of the admitted patients were exposed to physical restraint and those had significantly lower number of applications in the past year ( P = .020). The median restraint duration was 90 (60-150) minutes. Fifty-four (75.00%) of the physically restrained patients were male ( P < .001), and they were significantly younger (mean age 34.5 ± 12.1 vs. 39.5 ± 14.9, P = .005). Clinical diagnoses of restrained patients were significantly different, in favor of psychosis. While 42 (58.33%) of the restrained patients were substance-negative, 15 (20.83%) were screened as positive for at least 1 substance ( P < .001). Conclusion: Physically restrained patients differ from others with regard to age, gender, and number of previous applications. Fewer hospital applications in the past year were related to higher incidence of physical restraints.

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Section: Discussionmentioning

confidence: 95%

Physical Restraint Practices at the Emergency Department of a Mental Health Hospital

Güngör,

Poyraz,

Melenkiş

et al. 2024

Psychiatry and Clinical Psychopharmacology

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Retrospective study on suicide attempts among psychiatric emergencies admitted to the emergency department of a Regional hospital in Turkey

Boğan,

Beki̇rcan,

Boğan

et al. 2024

Curr Psychol

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Introduction The aim of this study was to determine the sociodemographic characteristics of psychiatric emergencies presenting to emergency departments (ED), the provisional diagnoses and reasons for consultation by emergency physicians, and to determine the rate of suicide attempts among patients presenting to emergency departments for psychiatric emergencies. Methods The records of all patients aged 18 years and older admitted to the emergency department of the Department of Emergency Medicine, a tertiary hospital, with either a pre-existing psychiatric diagnosis or a new psychiatric provisional diagnosis made by emergency physicians between January 2020 and December 2023 were reviewed. Results According to the data obtained in the study, it was determined that the most common provisional diagnoses made by emergency physicians in psychiatric emergencies were suicide attempts (41.88%), agitation (21.94%), schizophrenia (8.44%), psychosis (7.91%) and manic attack (6.54%). It was found that 49.3% of psychiatric emergencies resulted in discharge and 25.5% resulted in hospitalisation. Among the provisional diagnoses, depression, mutism and sleep disorders were most commonly associated with refusal of treatment, while depression and suicide were the most common reasons for hospitalisation. Among psychiatric emergency patients who attempted suicide, medication, sharp objects and chemicals were the most common substances ingested. Discussion In this study, it was determined that a great portion of the emergency psychiatric cases admitted to the emergency department consisted of patients who attempted suicide. However, due to the crowdedness and fast pace of emergency departments, it is understood that in psychiatric emergencies, epidemiological profile data are missing in the files of the cases and detailed medical history cannot be obtained from the patients We think that recording better data of patient who admitted a psychiatric condition to the emergency department will provide better information about the patients in future visits and improve the care to be provided. Psychiatrists and psychiatric nurses recommend the implementation of emergency department-based rehabilitation programs for these patients.

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Assessment of the patients diagnosed with conversion disorder in the emergency department

Evrın¹,

Kaykısız

2018

Ortadogu Tıp Derg

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Aim: Conversion disorder is defined as a specific disorder that accompanies the psychological conflict, has one or more neurological symptoms and in which there is a loss of bodily functioning that would seem to a physical disturbance. The aim of this study was to determine the ratio of the patients diagnosed with conversion disorder to all patients in the emergency department and to investigate the sociodemographic and clinical characteristics of the patients, attitudes and treatment approaches of the physicians. Material and Method: This cross sectional, retrospective study was conducted at a governmental secondary care hospital. After approval from the ethics committee, data pertaining to patients aged at least 18 years who had presented to the ED with various symptoms and had diagnosis of conversion was studied between July 1 and December 31, 2017. The exclusion criteria were as follows: age of less than 18 years, patients with additional pathology besides conversion disorder, patients with a lack of psychiatric consultation and patients whose data cannot be accessed from the system. A p value less than 0.05 was considered statisticallysignificant. Results: A total of 124 patients were included in the study. 71% (n: 88) of the patients were female, 54.8% (n: 68) were single. 17.7% (n = 22) of the patients had comorbid disease.There was a stressor event in all patients before hospital admission. %50 of patients were younger than 23 years. The most common complaint was syncope. 93 patients admitted by ambulance. There was the prior conversion disorder history in 66.1%. Any medical examinations were not required in 61.3% of the patients. The mean elapsed time in all patients was 135 min. Between in patients transported by ambulance and in walk-in patients, there was a statistically significant difference in terms of mean elapsed time between the patients' emergency service admission and discharge from hospital. Conclusion: It was detected that the conversion disorder was more commonly seen in female gender and young age group, the most common complaint of conversion disorder was syncope, most of the patients with conversion disorder had similar complaints before, patients with conversion disorder often preferred to transport to the hospital with ambulance, the patients who received the red code according to the triage code and patients with conversion disorder were examined in almost the same time period and the patients with conversion disorder stayed in emergency department for long hours.

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Who is seeking Emergency Care at the Emergency Psychiatric Ward of Bakirkoy Mental Health and Neurological Diseases Education and Research Hospital? A cross-sectional definitive study

Cited by 3 publications

References 0 publications

Physical Restraint Practices at the Emergency Department of a Mental Health Hospital

Physical Restraint Practices at the Emergency Department of a Mental Health Hospital

Retrospective study on suicide attempts among psychiatric emergencies admitted to the emergency department of a Regional hospital in Turkey

Assessment of the patients diagnosed with conversion disorder in the emergency department

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