Psychiatric Emergencies in a Tertiary Care Hospital

Abstract

People with psychiatric problems often visit a general hospital. Many of them require emergency
service. B P Koirala Institute of Health Sciences (BPKIHS) is one of the few health institutes in Nepal
providing comprehensive 24-hour psychiatric emergency service. This study aims to document the
pattern of psychiatric emergencies in a tertiary care hospital of Eastern Nepal.
All psychiatric emergencies referred from different departments in 30 random days during a sixmonth
period were enrolled. This is a descriptive study with convenience sampling method where
the diagnoses were made based on the‘International Classifi cation of Disease and Infi rmity’ (ICD-
10).
One hundred twenty-nine cases were referred in the study period. The M:F ratio was 1.3:1. The
service users were predominantly young adults. The majority of cases were seen in the emergency
department and medical ward. The most common causes for the consultation were behavioral
problems (39%), altered consciousness (32%) and somatic complaints (17%). Approximately 83%
received the diagnosis of Category F of the ICD-10. Mental and behavioral disorder due to substance
use (F10-19) was the most common disorder (30%), followed by mood/affective disorders (23%)
and neurotic, stress-related anxiety disorders (16%). Roughly 46% had co-morbid physical illnesses
and 8% received only a physical diagnosis. About 20% had attempted suicide using different means,
poisoning being the most common.
Emergency psychiatric consultation for mental problems is sought by almost all departments of a
general hospital. These consultations are most commonly sought for substance use, mood or anxiety
disorders.
Key Words: Behavioral problems, psychiatric emergency, psychiatric disorders, substance abuse.