Emergency Psychiatric Problems

A psychiatric emergency is a disturbance in thoughts moods and actions that cause sudden distress to the individual or sudden disability, thus requiring immediate management of such disorders.

Around 1in 5 of the world’s children and adolescents have a mental disorders.

A psychiatric emergency is a dangerous or life-threatening situation in which a patient needs immediate attention.

Types of Psychiatric Emergencies

1) A new psychiatric disorder with acute onset

2) A chronic psychiatric disorder with relapse

3) An abnormal response to a stressful situation

4) Iatrogenic emergency

a) side effects or toxicity of the psychotropic medication

b) psychiatric symptomatology as a side effect or toxicity of other medications

5) Alcohol or drug dependence

a) overdose

b) as withdrawal syndrome

c) complications

d) deliberate harm to self or others

Types of problems

1) Social problems – family separation, poverty, lack of privacy, loss of livelihood

2) Mental Health problems – depression, schizophrenia, acute stress reduction, use of alcohol and drugs, post-traumatic stress disorders

People with severe mental disorders are especially vulnerable during emergencies and need access to mental health care and other basic needs

Etiology

There are some common causes of mental illness:

a) psychiatric disorder

b) depression

c) alcoholism and drug dependence

d) schizophrenia

2) Physical factors – people with incurable or painful physical disorders like AIDS, Cancer , and Kidney failure often leads to emergency care and develop psychiatric disorders.

3) Psychosocial factors – it is a very important reason for arising psychiatric disorders such as failure in examination, marital difficulties, divorce, family disputes, failure in love etc.

Psychological factors lead to

1) stupor and catatonic syndrome

2) excited behaviour and violence

It is due to mania, depression, drug and alcohol dependence, and organic and Non-organic psychiatric disorders.

4) Other Psychiatric emergencies are:

a) severe depression

b) insomnia

c) hyperventilation syndrome

d) anorexia nervosa

e) drug or alcohol use disorder

f) psychological crisis( marital conflict, occupational and financial difficulties)

g) panic disorder

h) acute psychosis

Sadness

5)Suicide- it is the most commonest cause of death among psychiatric patients. It is a crisis that causes intense suffering and feelings of hopelessness and helplessness.

Examination

When anyone is faced with a psychiatric emergency, it is important to combine speed with obtaining a complete history/information.

1) Psychiatric history – always obtain a history from both the parents and the informants. Informants may be more knowledgeable and may provide more relevant information.

a) chief complaint

b) recent life changes

c) level of adjustment

d) past history

e) family history

f) drug and alcohol history

2) Detailed general physical and neurological examination

3) Mental status examination

People with a severe disorder die 10to 20 years earlier than the general age consideration.

Mental, Neurological and substance use disorders make up 10% of the global burden of disease and 30% of the non-fatal disease burden.

Management

1) Medication

2) Psychotherapy

3) Electroconvulsive therapy

4) Cognitive behaviour therapy

5) Find out the reason and treat accordingly

Emergency treatment should be on immediate medical care (diagnosis and treatment of the underlying psychiatric problems) and an attempt to establish a bond with the patients.

There are some tips for improving mental health:

1) Get enough sleep

2) see a therapist

3) spend time in nature

4) pursue a hobby

5) spend less time with devices, gadgets and electronics

6) connect with family and friends

7) express yourself

8) forgive yourself

9) practice deep calm breathing

10) do some exercise and yoga

Mental Illness

So, I think, all of you know enough about it and living with family and friends stress-free.

Dr S.k.jha