General Hospital Psychiatry
Volume 26, Issue 5 , Pages 405-410 , September 2004

Medical screening in the emergency department for psychiatric admissions: a procedural analysis

  • Robert J. Gregory, M.D.

      Affiliations

    • Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 315 464 3169; fax: +1 315 464 3163.
    • ,
  • Nikhil D. Nihalani, M.D.

      Affiliations

    • Department of Psychiatry, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA
    • ,
  • Elliot Rodriguez, M.D.

      Affiliations

    • Department of Emergency Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA

Received 29 December 2003 ,Accepted 6 April 2004.

References 

  1. Williams ER, Shepherd SM. Medical clearance of psychiatric patients. Emerg. Med. Clin. North Am. 2000;18:185–198
  2. Walter-Ryan WG, Alarcon RD, Meadows DT. Toward a profile of medically ill psychiatric patients. South Med. J. 1987;80:822–826
  3. Madsen AL, Aakerlund LP, Pederson DM. Somatic illness in psychiatric patients. Ugeskr. Laeger. 1997;159:4508–4511
  4. Abiodun OA. Physical morbidity in a psychiatric population in Nigeria. Gen. Hosp. Psychiatry. 2000;22:195–199
  5. Dan B, Gregoire F, Verbanck P, et al. Organic morbidity of hospitalized psychiatric population. Acta Clin. Belg. 1991;46:209–218
  6. Hall RC, Gardner ER, Popkin MK, et al. Unrecognized physical illness prompting psychiatric admission: a prospective study. Am. J. Psychiatry. 1981;138:629–635
  7. Koranyi EK, Potoczny WM. Physical illness underlying psychiatric symptoms. Psychother. Psychosom. 1992;58:155–160
  8. Koran LM, Sheline Y, Imai K, et al. Medical disorders among patients admitted to a public-sector psychiatric inpatient unit. Psychiatr. Serv. 2002;53:1623–1625
  9. Koran LM, Sox HC, Marton KI, et al. Medical evaluation of psychiatric patients. Arch. Gen. Psychiatry. 1989;46:733–740
  10. Henneman PL, Mendoza R, Lewis RJ. Prospective evaluation of emergency department medical clearance. Ann. Emerg. Med. 1994;24:672–677
  11. Olshaker JS, Browne B, Jerrard DA, et al. Medical clearance and screening of psychiatric patients in the emergency department. Acad. Emerg. Med. 1997;4:124–128
  12. Carlson RJ, Nayar N, Suh M. Physical disorders among emergency psychiatric patients. Can. J. Psychiatry. 1981;26:65–67
  13. Riba M, Hale M. Medical clearance: fact or fiction in the hospital emergency room. Psychosomatics. 1990;31:400–404
  14. Miller AK, Tepper A, Sieber K. Historical risks of tuberculin skin test conversion among non-physician staff at a large urban hospital. Am. J. Ind. Med. 2002;42:228–235
  15. Assal F, Cummings JL. Neuropsychiatric symptoms in dementias. Curr. Opin. Neurol. 2002;15:445–450
  16. Koponen S, Taiminen T, Portin R, et al. Axis I and II psychiatric disorders after traumatic brain injury: a 30-year follow up study. Am. J. Psychiatry. 2002;159:1315–1321
  17. Lamberg L. Psychiatric symptoms common in neurological disorders. J. Am. Med. Assoc. 2001;286:154–156
  18. Thompson Cl, Reid A. Behavioural symptoms among people with severe and profound intellectual disabilities: a 26 year follow up study. Br. J. Psychiatry. 2002;181:67–71
  19. Hutto B. Subtle psychiatric presentations of endocrine diseases. Psychiatr. Clin. North Am. 1998;21:905–916
  20. Velasco PJ, Manshadi M, Breen K, Lippmann S. Psychiatric aspects of parathyroid disease. Psychosomatics. 1999;40:486–490
  21. Sonino N, Fava GA. Psychiatric disorders associated with Cushing's syndrome: epidemiology, pathophysiology and treatment. CNS Drugs. 2001;15:361–373
  22. Crimlisk HL. The little imitator-porphyria: a neuropsychiatric disorder. J. Neurol. Neurosurg. Psychiatry. 1997;62:319–328
  23. Green AI, Austin CP. Psychopathology of pancreatic cancer: a psychobiologic probe. Psychosomatics. 1993;34:208–221
  24. Cole MG, McCusker J, Dendukuri N, et al. Symptoms of delirium among elderly medical inpatients with or without dementia. J. Neuropsychiatry Clin. Neurosci. 2002;14:167–175
  25. Webb WL, Gehi M. Electrolyte and fluid imbalance: neuropsychiatric manifestations. Psychosomatics. 1981;22:199–203
  26. Marsh L, Rao V. Psychiatric complications in patients with epilepsy: a review. Epilepsy Res. 2002;49:11–33
  27. Webster R, Holroyd S. Prevalence of psychotic symptoms in delirium. Psychosomatics. 2000;41:519–522
  28. Teuth MJ. Diagnosing psychiatric emergencies in the elderly. Am. J. Emerg. Med. 1994;12:364–369
  29. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.. Washington (DC): American Psychiatric Association; 1994;
  30. Lipowski ZJ. Delirium (acute confusional states). J. Am. Med. Assoc. 1987;258:1789–1792
  31. Reeves RR, Pendarvis EJ, Kimble R. Unrecognized medical emergencies admitted in psychiatric units. Am. J. Emerg. Med. 2000;18:390–393
  32. Miller NS, Ries RK. Drug and alcohol dependence and psychiatric populations: the need for diagnosis, intervention, and training. Compr. Psychiatry. 1991;32:268–274
  33. Klien JF. Adverse psychiatric effects of systemic glucocorticoid therapy. Am. Fam. Physician. 1992;46:1469–1474
  34. Anfinson TJ, Kathol RG. Screening laboratory evaluation in psychiatric patients: a review. Gen. Hosp. Psychiatry. 1992;14:248–257
  35. Sox HC, Koran SM, Sox CH, et al. A medical algorithm for detecting physical disease in psychiatric patients. Hosp. Community Psychiatry. 1989;40:1270–1276
  36. Tintinnali JE, Peacock FW, Wright MA. Emergency medical evaluation of psychiatric patients. Ann. Emerg. Med. 1994;23:859–862
  37. Korn CS, Currier GW, Henderson SO. “Medical clearance” of psychiatric patients without medical complaints in the emergency department. J. Emerg. Med. 2000;18:173–176
  38. Ferguson B, Dudleston K. Detection of physical disorderly in newly admitted psychiatric patients. Acta Psychiatr. Scand. 1986;74:485–489
  39. Dubin WR, Weiss KJ, Zeccardi JA. Organic brain syndrome: the psychiatric imposter. J. Am. Med. Assoc. 1983;249:60–62
  40. Serper MR, Allen MH. Emergency psychiatry: rapid screening for cognitive impairment in the psychiatric emergency service: I. Cognitive screening batteries. Psychiatr. Serv. 2002;53:1527–1529
  41. Copersino ML, Serper M, Allen MH. Emergency psychiatry: rapid screening for cognitive impairment in the psychiatric emergency service: II. A flexible test strategy. Psychiatr. Serv. 2003;54:314–316
  42. Inouye SK, VanDyck CH, Alessi CA, Balkin S, Siegel AP, Horwitz RI. Clarifying confusion: the confusion assessment method: a new method for the detection of delirium. Ann. Intern. Med. 1990;113:941–948
  43. American College of Emergency Physicians. Clinical policy for the initial approach to patients presenting with altered mental status. Ann. Emerg. Med. 1999;33:251–281
  44. Kolman PB. The value of laboratory investigations of elderly psychiatric patients. J. Clin. Psychiatry. 1984;45:112–116
  45. Dolan JG, Mushlin AI. Routine laboratory testing for medical disorders in psychiatric inpatients. Arch. Intern. Med. 1985;145:2085–2088
  46. Thomas CJ. The use of screening investigations in psychiatry. Br. J. Psychiatry. 1979;135:67–72
  47. Willett AB, King T. Implementation of laboratory screening procedures on a short-term psychiatric inpatient unit. Dis. Nerv. Syst. 1977;38:867–870
  48. Sheline Y, Kehr C. Cost and utility of routine admission laboratory testing for psychiatric inpatients. Gen. Hosp. Psychiatry. 1990;12:329–334
  49. Swaminathan S, Ramachandran R, Baskaran G, et al. Risk of development of tuberculosis in HIV-infected patients. Int. J. Tuberc. Lung Dis. 2000;4:839–844
  50. Griffin RG, Hoff GL. Tubercolosis screening in Kansas city homeless shelters. Mo. Med. 1999;96:496–499
  51. Jones SG. Evaluation of a human immunodeficiency virus rule out tuberculosis critical pathway as an intervention to decrease nosocomial transmission of tuberculosis in the inpatient setting. AIDS Patient Care STDS. 2002;16:389–394
  52. Sanchez M, Nicholls T, Currier GW. Risk factors for tuberculosis in the psychiatric emergency department. Emerg. Psychiatry. 1998;4:33–34
  53. Schiller MJ, Shumway M, Batki SL. Utility of routine drug screening in a psychiatric emergency setting. Psychiatr. Serv. 2000;51:474–478
  54. Elangovan N, Berman S, Meinzer A, Gianelli P, Miller H, Longmore W. Substance abuse among patients presenting at an inner-city psychiatric emergency room. Hosp. Community Psychiatry. 1993;44:782–784
  55. Claassen CA, Gilfillan S, Orsulak P, Carmody TJ, Battaglia J, Rush AJ. Substance use among patients with a psychotic disorder in a pychiatric emergency room. Psychiatr. Serv. 1997;48:353–358

PII: S0163-8343(04)00063-5

doi: 10.1016/j.genhosppsych.2004.04.006

General Hospital Psychiatry
Volume 26, Issue 5 , Pages 405-410 , September 2004

Article Tools