Psychiatric emergencies

Psychiatric emergencies

Suicide• Epidemiology• 10/10 000• More men• Increase with age• Unemployment and homelessness• Divorced and widowed• I and VI classes

Suicide

• Methods Males, car exhaust, guns hanging Females, over dosage• Psychiatric variables Depression commonest Alcoholism next 10% schizophrenics Personality disorders and drug abuse

Suicide

Assessment• Most give warning or make visit• Don’t hesitate asking• Assessment of intent;• Seriousness of method• Planned, alone, precautions for discovery• Previous attempt• Will

Psychiatric emergencies

Deliberate self harm• More in women• More young• Lower social class• More in cities• Unemployment• High risk of suicide • Alcohol, personality, forensic

Delibrate self harm

Management• Assess suicide risk• Physical care• Problem solving social or psychological

Psychiatric emergencies

Aggressive behavior• Personality• Drug abuse• Schizophrenia• Mania• Toxic confusional statesManagement• Rapport• Underlying cause• Drugs

Psychiatric emergencies

Panic anxiety I v diazepamconversion Sever depressionECT

Aspects of forensic psychiatry

• doctor patient relation Confidentiality Compulsory admission• civil law Guardianship Testamentary capacity• criminal law Fitness to stand trial Criminal responsibility