Pre-clinical psychiatric emergencies in the physician-based emergency system of a German metropolis

Pre-clinical Psychiatric Emergency Situations (PES) gain more scientific in terest. First investigations revealed them to be the third major cause for emergency physician (EP) calls. However, there is still very little data co ncerning prevalence, diagnosis and therapy. Methods: A retrospective analys is of all anonymised EP protocols of the year 1995 in the city of Hamburg w as performed. Data of each multiple-choice category was evaluated as well a s handwritten and personal notes to determine prevalence, diagnoses and the rapy of PES. Results: 2550 out of 26347 protocols (9.7%) revealed to have a psychiatric disturbance as a major cause for the call. The most frequent d iagnoses in the overall young (average age: 43.1 +/- 17.6 years) and male ( 60.3 %) population were found to be alcoholic intoxication (34%), state of agitation (23 %) and suicide attempts (ZZ %). In 55% the emergencies could be considered as purely psychiatric; in 35% as a combined somatic-psychiatr ic emergency. A specific psychopharmacological treatment was not performed. Conclusions: Psychiatric patients are a considerable group in pre-clinical emergency medicine, however, disturbances are much too rarely documented, diagnosed and treated. Training programs are necessary. Psychiatry has to p lay a more active role in planning and performing these programs.