Characteristics of psychiatric emergencies and the choice of intervention strategies


Ulrich Schnyder, Psychiatrische Puliklilik, Universitätsspital, Ramistrasse 100, 8091 Zürich, Switzerland


The aim of this study was to describe the sociodemographic, contextual and clinical characteristics of a consecutive sample of 3611 psychiatric emergency visits to a Swiss university general hospital, and to investigate their associations with different intervention strategies. All consultations were documented by a questionnaire covering sociodemographic and diagnostic data as well as information about the consultation and the disposition decision. In a total of 1093 cases (30.3%) no further emergency intervention was required, in 1287 cases (35.6%) patients were offered out-patient crisis intervention, and in 1231 cases (34.1%) patients were hospitalized. Social integration and the presence of an easily recognizable precipitating stressor were associated with referral to out-patient crisis intervention. In logistic regression analyses, referral by the police or by health professionals (in contrast to self-referral or referral by relatives), current diagnosis of a psychotic disorder, and previous hospitalizations were the most powerful predictors of hospitalization. The presence of a precipitating stressor related to the patient's social network decreased the likelihood of hospitalization. The findings indicate a need for facilities offering brief admission, allowing for extended emergency assessments.