Psychiatric emergencies in a general hospital setting

Abstract

A psychiatric emergency is any disturbance in thoughts, feelings, or actions for
which immediate therapeutic intervention is necessary. For a variety of reasons, such
as the growing incidence of violence, the increased appreciation of the role of medical
disease in altered mental status, and the epidemic of alcohol dependence and other
substance related disorders- the number of emergency patients is on rise. The present
work was undertaken with the aim to study socio-demographic and diagnostic profile of
patients for whom psychiatric evaluation was sought in the Emergency Room [ER] of
Tribhuvan University Teaching Hospital, Kathmandu during a three-month period. It
was a prospective, cross-sectional, descriptive study. Majority of the patients were of
age 11-30 years (57.7%), more than half of the patients were married (64.4%,) and
patients coming from Kathmandu valley (62.5%) outnumbered patients coming from
outside. Only 46% of the patients attended the ER within 24 hours of onset of current
problem. Out of the patients who received the diagnosis of Category F- Mental and
Behavioural disorders of the ICD-10 (79.8%), 43.4% were suffering from the Neurotic,
stress-related and somatoform disorders and 20% were suffering from Mood disorders.
Out of the remaining 20.2% patients, one third each belonged to those who committed
intentional self harm, who were suffering from neurological disorders, and who were
found to be suffering from systemic diseases. Emergency psychiatry is yet to draw
attention of administrators and policy makers, which is reflected by the fact that only
TUTH provides 24 hours psychiatric emergency services in the whole country.