Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study
Background: Medical clearance for patients presenting with psychiatric-like illnesses has been a topic of debate for years. This study aimed to determine the predictors of diagnosing psychiatric illness in the emergency department (ED). Methods: The study included patients aged ≥13 years presenting...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Current Medical Issues |
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| Online Access: | https://journals.lww.com/10.4103/cmi.cmi_118_24 |
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| author | Ibrahim Khamis Abdullah Almamari Darpanarayan Hazra Awatif K. Alsarrai Al-Alawi |
| author_facet | Ibrahim Khamis Abdullah Almamari Darpanarayan Hazra Awatif K. Alsarrai Al-Alawi |
| author_sort | Ibrahim Khamis Abdullah Almamari |
| collection | DOAJ |
| description | Background:
Medical clearance for patients presenting with psychiatric-like illnesses has been a topic of debate for years. This study aimed to determine the predictors of diagnosing psychiatric illness in the emergency department (ED).
Methods:
The study included patients aged ≥13 years presenting to the adult ED with psychiatric-like illness over 1 year (January 01, 2019–December 31, 2019). Medical charts were reviewed, and multiple variables were coded and analyzed.
Results:
Our study included 361 patients, constituting 0.89% of the total ED visits. The majority (335 patients, 92.8%) were diagnosed with primary psychiatric illnesses, while 26 patients (7.2%) had underlying medical conditions contributing to their symptoms. Bivariate and multivariate logistic regression analysis identified the predictors for initial psychiatric diagnoses, including abnormal behavior (odd’s ratio [OR]: 8.29; 95% confidence interval [CI]: 2.04–33.65; P < 0.01) and substance abuse (adjusted OR: 17.27; 95% CI: 3.88–76.88; P < 0.01). Notable findings involved family history or previous psychiatric illness (OR: 2.32; 95% CI: 0.59–6.09; P < 0.01), absence of medical comorbidities (adjusted OR: 2.47; 95% CI: 1.05–5.86; P < 0.01), and no new medication initiation before illness (OR: 6.43; 95% CI: 1.52–27.18; P < 0.01), normal sensorium (adjusted OR: 2.84; 95% CI: 0.81–10.00; P < 0.01) and intact orientation (adjusted OR: 6.73; 95% CI: 1.24–36.42; P < 0.01) demonstrated statistically significant predictors of an initial psychiatric diagnosis in the ED.
Conclusion:
Significant predictors of initial psychiatric illness included abnormal behavior, substance abuse, family psychiatric history, absence of major medical conditions, no recent medication changes before illness onset, normal sensorium and orientation, and normal laboratory markers at presentation. |
| format | Article |
| id | doaj-art-bf9b44e2063c4be9bfc052b8b2853330 |
| institution | Kabale University |
| issn | 0973-4651 2666-4054 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Current Medical Issues |
| spelling | doaj-art-bf9b44e2063c4be9bfc052b8b28533302025-02-10T14:49:06ZengWolters Kluwer Medknow PublicationsCurrent Medical Issues0973-46512666-40542025-01-01231253110.4103/cmi.cmi_118_24Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional StudyIbrahim Khamis Abdullah AlmamariDarpanarayan HazraAwatif K. Alsarrai Al-AlawiBackground: Medical clearance for patients presenting with psychiatric-like illnesses has been a topic of debate for years. This study aimed to determine the predictors of diagnosing psychiatric illness in the emergency department (ED). Methods: The study included patients aged ≥13 years presenting to the adult ED with psychiatric-like illness over 1 year (January 01, 2019–December 31, 2019). Medical charts were reviewed, and multiple variables were coded and analyzed. Results: Our study included 361 patients, constituting 0.89% of the total ED visits. The majority (335 patients, 92.8%) were diagnosed with primary psychiatric illnesses, while 26 patients (7.2%) had underlying medical conditions contributing to their symptoms. Bivariate and multivariate logistic regression analysis identified the predictors for initial psychiatric diagnoses, including abnormal behavior (odd’s ratio [OR]: 8.29; 95% confidence interval [CI]: 2.04–33.65; P < 0.01) and substance abuse (adjusted OR: 17.27; 95% CI: 3.88–76.88; P < 0.01). Notable findings involved family history or previous psychiatric illness (OR: 2.32; 95% CI: 0.59–6.09; P < 0.01), absence of medical comorbidities (adjusted OR: 2.47; 95% CI: 1.05–5.86; P < 0.01), and no new medication initiation before illness (OR: 6.43; 95% CI: 1.52–27.18; P < 0.01), normal sensorium (adjusted OR: 2.84; 95% CI: 0.81–10.00; P < 0.01) and intact orientation (adjusted OR: 6.73; 95% CI: 1.24–36.42; P < 0.01) demonstrated statistically significant predictors of an initial psychiatric diagnosis in the ED. Conclusion: Significant predictors of initial psychiatric illness included abnormal behavior, substance abuse, family psychiatric history, absence of major medical conditions, no recent medication changes before illness onset, normal sensorium and orientation, and normal laboratory markers at presentation.https://journals.lww.com/10.4103/cmi.cmi_118_24acute psychosismedical clearancepsychiatric illnesspsychiatry |
| spellingShingle | Ibrahim Khamis Abdullah Almamari Darpanarayan Hazra Awatif K. Alsarrai Al-Alawi Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study Current Medical Issues acute psychosis medical clearance psychiatric illness psychiatry |
| title | Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study |
| title_full | Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study |
| title_fullStr | Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study |
| title_full_unstemmed | Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study |
| title_short | Assessing the Role of Emergency Physicians in Medical Clearance: Predictors of Diagnosing Psychiatric Illness in the Emergency Department – A Retrospective Cross-sectional Study |
| title_sort | assessing the role of emergency physicians in medical clearance predictors of diagnosing psychiatric illness in the emergency department a retrospective cross sectional study |
| topic | acute psychosis medical clearance psychiatric illness psychiatry |
| url | https://journals.lww.com/10.4103/cmi.cmi_118_24 |
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