Psychiatr Prax 2017; 44(01): 29-35
DOI: 10.1055/s-0035-1552681
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Psychiatrische Notfälle auf der medizinischen Notaufnahme des Universitätsklinikums Ulm in den Jahren 2000 und 2010

Psychiatric Emergencies in the Emergency Room of the Ulm University Hospital in 2000 and 2010
Roland W. Freudenmann*
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
Johannes Espe*
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
Dirk Lang
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
3   Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinik Ulm
,
Jochen Klaus
2   Klinik für Innere Medizin I, Universitätsklinikum Ulm
,
Maximilian Gahr
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
,
Carlos Schönfeldt-Lecuona
1   Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm
› Author Affiliations
Further Information

Publication History

Publication Date:
09 July 2015 (online)

Zusammenfassung

Ziel der Studie: Über psychiatrische Notfälle (PN) auf der medizinischen Notaufnahme (MNA) ist wenig bekannt.

Methodik: Retrospektive Analyse aller PN auf der MNA des Universitätsklinikums Ulm im Jahr 2000 vs. 2010.

Ergebnisse: Die Zahl der PN stieg um 16,5 % in 10 Jahren, ihr Anteil an allen Notfällen aber sank. Intoxikationen aller Art dominierten. Das Alter von Patienten mit einer Alkoholintoxikation sank. Suizidversuche nahmen zu. Grundsätzlich häuften sich PN abends und nachts.

Schlussfolgerung: Unsere Studie liefert erstmals Daten zu Entwicklungen von PN auf einer MNA in Deutschland und damit Ansatzpunkte für eine Optimierung der Versorgung.

Abstract

Objective: Despite of the importance of psychiatric emergencies (PE) requiring treatment at an emergency room (ER) little is known about their frequency and current trends in terms of quantity and quality.

Methods: A retrospective analysis of all PE treated at the ER of the University Hospital Ulm (Germany) in 2000 and 2010.

Results: 6 % (2000) or 5 % (2010) of the ER cases were PE. Despite an increase from 369 to 430 cases (+ 16,5 %) their share decreased because of an even stronger increase of other emergencies (+ 33 %). The most frequent PE in 2000 was alcohol intoxication (37,7 %), while it was intoxication with prescribed and/or illicit drugs in 2010 (47,9 %). Patients with alcohol intoxications were significantly younger in 2010 as compared with 2000. Suicide attempts were seen in every fourth PE. They were significantly more frequent in 2010. PEs were generally more frequent in the evening and over the night.

Conclusion: This study provides first insight into current trends in PE treated at the ER in Germany. Our data provide an empirical starting point for optimizing clinical care, although the study is limited by its retrospective and mono-centric design.

* Beide Autoren haben in gleichen Teilen zum Manuskript beigetragen.


 
  • Literatur

  • 1 Pajonk FG, Poloczek S, Schmitt TK. Der psychiatrische Notfall – Abgrenzung zu Psychotraumatologie und Krise. Notfall Rettungsmed 2000; 3: 363-370
  • 2 Sefrin P. Schnittstelle Notarztdienst und Notaufnahme. Notarzt 2010; 26: 256-259
  • 3 Hazlett SB, McCarthy ML, Londner MS et al. Epidemiology of adult psychiatric visits to US emergency departments. Acad Emerg Med 2004; 11: 193-195
  • 4 Larkin GL, Claassen CA, Emond JA et al. Trends in U.S. emergency department visits for mental health conditions, 1992 to 2001. Psychiatr Serv 2005; 56: 671-677
  • 5 Pandya A, Larkin GL, Randles R et al. Epidemiological trends in psychosis-related Emergency Department visits in the United States, 1992–2001. Schizophr Res 2009; 110: 28-32
  • 6 Kropp S, Andreis C, te Wildt B et al. Psychiatric patients turnaround times in the emergency department. Clin Pract Epidemiol Ment Health 2005; 1: 27
  • 7 Kropp S, Andreis C, te Wildt B et al. Charakteristik psychiatrischer Patienten in der Notaufnahme. Psychiat Prax 2007; 34: 72-75
  • 8 Ziegenbein M, Anreis C, Bruggen B et al. Possible criteria for inpatient psychiatric admissions: which patients are transferred from emergency services to inpatient psychiatric treatment?. BMC Health Serv Res 2006; 6: 150
  • 9 Puffer E, Messer T, Pajonk FG. Psychiatrische Versorgung in der Notaufnahme. Anaesthesist 2012; 61: 215-223
  • 10 Larkin GL, Smith RP, Beautrais AL. Trends in US emergency department visits for suicide attempts, 1992–2001. Crisis 2008; 29: 73-80
  • 11 Hiles S, Bergen H, Hawton K et al. General hospital-treated self-poisoning in England and Australia: Comparison of presentation rates, clinical characteristics and aftercare based on sentinel unit data. J Psychosom Res 2015; 78: 356-362
  • 12 Smith RP, Larkin GL, Southwick SM. Trends in U.S. emergency department visits for anxiety-related mental health conditions, 1992–2001. J Clin Psychiatry 2008; 69: 286-294
  • 13 Marchesi C, Brusamonti E, Borghi C et al. Anxiety and depressive disorders in an emergency department ward of a general hospital: a control study. Emerg Med J 2004; 21: 175-179
  • 14 te Wildt BT, Andreis C, Auffahrt I et al. Alcohol related conditions represent a major psychiatric problem in emergency departments. Emerg Med J 2006; 23: 428-430
  • 15 Vazirian M, Jerry JM, James J et al. Bath Salts in the Emergency Department: A Survey of Emergency Clinicians’ Experience With Bath Salts-Intoxicated Patients. J Addict Med 2015; 9: 94-98
  • 16 Hampton LM, Daubresse M, Chang HY et al. Emergency Department Visits by Children and Adolescents for Antipsychotic Drug Adverse Events. JAMA Psychiatry 2015; 72: 292-294
  • 17 Melis G, Pia G, Piras I et al. Mental disorders and HIV infection in the emergency department: epidemiology and gender differences. Intern Emerg Med DOI: 10.1007/s11739-014-1175-3.
  • 18 Gaddini A, Franco F, Biscaglia L et al. An urban Italian study on emergency room utilisation by immigrants suffering from mental disorders in Rome, 2000–2004. Eur Psychiatry 2008; 23: 118-124
  • 19 Hartley D, Ziller EC, Loux SL et al. Use of critical access hospital emergency rooms by patients with mental health symptoms. J Rural Health 2007; 23: 108-115
  • 20 Fulbrook P, Lawrence P. Survey of an Australian general emergency department: estimated prevalence of mental health disorders. J Psychiatr Ment Health Nurs 2015; 22: 30-38
  • 21 Healey C, Rahman A, Faizal M et al. Underage drinking in the UK: changing trends, impact and interventions. A rapid evidence synthesis. Int J Drug Policy 2014; 25: 124-132
  • 22 Johnston LD, O’Malley PM, Miech RA et al. Monitoring the Future national survey results on drug use: 1975–2014: Overview, key findings on adolescent drug use. Ann Arbor, MI: Institute for Social Research, The University of Michigan; 2015
  • 23 Preacher KJ. Calculation for the Chi-Square test: An interactive calculation tool for chi-square tests of goodness of fit and independence. [Computer software] (2001). Im Internet: http://www.quantpsy.org/ (Stand: 08.06.2015)
  • 24 Böcking W, Ahrens U, Kirch W et al. First results of the introduction of DRGs in Germany and overview of experience from other DRG countries. J Publ Health 2005; 13: 128-137
  • 25 Xiang Y, Zhao W, Xiang H et al. ED visits for drug-related poisoning in the United States, 2007. Am J Emerg Med 2012; 30: 293-301
  • 26 Freudenmann RW, Baumgarten E, Hawlik AE et al. Liquid Ecstasy in der Allgemeinpsychiatrie: eine Fallserie. Fortschr Neurol Psychiatr 2013; 81: 88-94
  • 27 Morgan OW, Griffiths C, Majeed A. Interrupted time-series analysis of regulations to reduce paracetamol (acetaminophen) poisoning. PLoS Med 2007; 4: e105
  • 28 Pajonk FG, Bartels HH, Biberthaler P et al. Der psychiatrische Notfall im Rettungsdienst – Häufigkeit, Versorgung und Beurteilung durch Notärzte und Rettungsdienstpersonal. Nervenarzt 2001; 72: 685-692
  • 29 Biancosino B, Vanni A, Marmai L et al. Factors related to admission of psychiatric patients to medical wards from the general hospital emergency department: a 3-year study of urgent psychiatric consultations. Int J Psychiatry Med 2009; 39: 133-146