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Social Psychiatry and Psychiatric Epidemiology
Published in: Social Psychiatry and Psychiatric Epidemiology 7/2006

01-07-2006 | ORIGINAL PAPER

Who visits the psychiatric emergency room for the first time?

Authors: Ronny Bruffaerts, PhD, Marc Sabbe, MD, PhD, Koen Demyttenaere, MD, PhD

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 7/2006

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Abstract

Objective

To examine patient and system characteristics of first-time (“incident”) vs. recurrent (“recurrent”) use of a psychiatric emergency room (PER).

Methods

Data on demographic and clinical characteristics and health service utilization were collected for incident and recurrent users (n=3,719) who visited the PER of the university hospital in Leuven, Belgium, between March 2000 and March 2002.

Results

About 64% (n=2,368) were incident and 36% (n=1,351) were recurrent users. The PER was the first treatment setting ever for 50% of the incident users. Incident users were most likely over 69 years (OR=2.84, P<0.001), employed (OR=2.21, P<0.001), or referred by a health care professional (OR=1.72, P<0.001). They were less likely to have a personality disorder (OR=0.40, P<0.001) or to have used inpatient or outpatient services in the past (OR’s 0.11 and 0.65, respectively, P<0.001). About 44% were admitted, 38% referred for outpatient treatment, 9% referred to the outpatient crisis-intervention program, and 9% refused any follow-up.

Conclusions

The PER was a first treatment setting ever for 1 in 3 patients. Incident and recurrent users differed in sociodemographic characteristics, pathways to care, service use, and the presence of a personality disorder. They did not differ in axis 1 disorders, comorbid mental disorders, or pathways after care.
Literature
1.
Gerson S, Bassuk E (1980) Psychiatric emergencies: an overview. Am J Psychiatry 137:1–11PubMed
2.
Ellison JM, Hughes DH, White KA (1989) An emergency psychiatry update. Hosp Comm Psychiatry 40:250–260
3.
Larkin GL, Claassen CA, Emond JA, Pelletier AJ, Camargo CA (2005) Trends in U.S. emergency department visits for mental health conditions, 1992 to 2001. Psychiatr Serv 56:671–677PubMedCrossRef
4.
Sledge WH, Astrachan B, Thompson K, Rakfeldt J, Leaf P (1995) Case management in psychiatry. Am J Psychiatry 152:1259–1265PubMed
5.
Allen MH (1999) Level 1 Psychiatric emergency services. Psychiatr Clin N Am 22:713–714CrossRef
6.
Kessler RC, Demler O, Frank RG, Olfson M, Pincus HA, Walters EE, Wang P, Wells KB, Zaslavsky AM (2005) Prevalence and treatment of mental disorders. N Engl J Med 352:2515–2523PubMedCrossRef
7.
Dhossche DM, Ghani SO (1998) A Study on recidivism in the psychiatric emergency room. Ann Clin Psychiatry 10:59–67PubMedCrossRef
8.
Ellison JM, Blum N, Barsky AJ (1986) Repeat visitors in the psychiatric emergency service: a critical review of the data. Hosp Comm Psychiatry 37:37–41
9.
First MB, Bell CB, Cuthbert B, Krystal JH, Malison R, Offord DR, Reiss D, Shea MT, Widiger TA, Wisner KL (2002) Personality disorders and relational disorders. In: Kupfer DJ, First MB, Regier DA (eds) A research agenda for DSM-V. American Psychiatric Association, Washington
10.
Oyewumi LK, Odejide O, Kazarian SS (1992) Psychiatric emergency services in a Canadian city: I. prevalence and patterns of use. Can J Psychiatry 37:91–95PubMed
11.
Munves P, Trimboli F, North A (1983) A study of repeat visits to a psychiatric emergency room. Hosp Comm Psychiatry 34:634–638
12.
Segal SP, Akutsu PD, Watson MA (1998) Factors associated with involuntary return to a psychiatric emergency service. Psychiatr Serv 49:1212–1217PubMed
13.
Slaby A, Perry P (1980–1981) Use and abuse of psychiatric emergency services. Int J Psychiatry Med 10:1–8CrossRef
14.
Spooren DJ, De Bacquer D, Van Heeringen K, Jannes C (1997) Repeated psychiatric referrals to Belgian emergency departments: a survival analysis of the time interval between first and second episodes. Eur J Emerg Med 4:61–67PubMed
15.
Sullivan PF, Bulik CM, Forman SD Mezzich JE (1999) Characteristics of repeat users of a psychiatric emergency service. Hosp Comm Psychiatry 44:376–380
16.
European Observatory on Health Care Systems (2000) Health care systems in transition: Belgium. WHO regional office for Europe, Copenhagen
17.
Alonso J, Ferrer M, Romera B, Vilagut G, Anyermeyer M, Bernert S, Brugha T, Taub N, McColgen Z, De Girolamo G, Polidori G, Mazzi F, De Graaf R, Vollebergh W, Bowman MA, Demyttenaere K, Gasquet I, Haro MJ, Palacin C, Autonell J, Katz SJ, Kessler R, Kovess V, Lépine JP, Arbabzedeh-Bouchez S, Ormel J, Bruffaerts R (2002) The European study of the epidemiology of mental disorders (ESEMeD/MHEDEA 2000) project: rationale and methods. Int J Met Psy Research 11:55–67CrossRef
18.
Bruffaerts R, Demyttenaere K (2005) Psychiatric emergency services in Belgium. Emerg Psychiatry 11 (summer):16–19
19.
Ministerie van Sociale Zaken, Volksgezondheid en Leefmilieu (1997) Handleiding voor de registratie van de Minimale Psychiatrische Gegevens. Ministerie van Sociale zaken, Volksgezondheid en Leefmilieu, Brussel
20.
American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, (4th edn). American Psychiatric Association, Washington DC
21.
Schnyder U, Valach L, Mörgeli H Heim E (1999) Patient-disease characteristics and coping strategies predict hospitalization in emergency psychiatry. Int J Psychiatry Med 29:75–90PubMedCrossRef
22.
Schnyder U, Klaghofer R, Leuthold A Buddeberg C (1999) Characteristics of psychiatric emergencies and the choice of intervention strategies. Acta Psychiatr Scand 99:179–187PubMed
23.
Lemeshow S, Hosmer DW (1982) A review of goodness of fit statistics for use in the development of logistic regression models. Am J Epidemiol 115:92–106PubMed
24.
Solbergsdottir E, Bjornsson G, Gudmundsson LS, Tyrfingsson T, Kristinsson J (2004) Validity of self-reports and drug use among young people seeking treatment for substance abuse or dependence. J Addict Dis 23:29–38PubMedCrossRef
25.
Lieberman PB, Baker FM (1985) The reliability of psychiatric diagnosis in the emergency room. Hosp Comm Psychiatry 36:291–293
26.
Vukmir RB, Kremen R, Dehart DA, Menegazzi J (1992) Compliance with emergency department patient referral. Am J Emerg Med 10:412–417CrossRef
27.
Warner MD, Peabody CA (1995) Reliability of diagnoses made by psychiatric residents in a general emergency department. Psychiatr Serv 46:1284–1286PubMed
28.
Lyons MJ, Jersky BA (2002) Personality disorders: epidemiological findings, methods, and concepts. In: Tsuang MT, Tohen M (Eds) Textbook in psychiatric epidemiology. Wiley, New York
29.
Bruffaerts R, Sabbe M, Demyttenaere K (2005) Predicting community stay among patients with repeated referrals to a psychiatric emergency service. Gen Hosp Psychiatry 27:269–274PubMedCrossRef
30.
McIntosh J, Worley N (1994) Beyond discharge: telephone follow-up and aftercare. J Psychosoc Nurs Ment Health Serv 32:21–27PubMed
31.
Fichtner CG, Flaherty JA (1993) Emergency psychiatry training and the decision to hospitalize. A longitudinal study of psychiatric residents. Acad Psychiatry 17:130–137
32.
Minoletti A, Perez E, Blouin A (1984) Compliance with referrals from psychiatric emergency services to ambulatory facilities: a 20 year literature review. Am J Soc Psychiatry 4:57–61
33.
Solomon P, Gordon B (1986) The psychiatric emergency room and follow-up services in the community. Psychiatr Q 58:119–127PubMedCrossRef
Metadata
Title
Who visits the psychiatric emergency room for the first time?
Authors
Ronny Bruffaerts, PhD
Marc Sabbe, MD, PhD
Koen Demyttenaere, MD, PhD
Publication date
01-07-2006
Publisher
Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 7/2006
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-006-0062-2

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