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BACKGROUND: Asylum seekers are found to be at high risk of mental health problems. Little is known about the use of acute psychiatric emergency services by asylum seekers.AIM: To describe the usage of an inpatient/outpatient psychiatric emergency service in Denmark by adult asylum seekers, and discuss clinical implications.METHOD: This descriptive study is based on retrospective data collected from patient charts during a 3-month period.RESULTS: A total of 31 evaluations were made (3.3% of all evaluations), based on 23 asylum seekers. Patients originated from 16 different countries, were predominantly male and married. The group consisted primarily (61%) of failed asylum seekers. Most patients (81%) presented with relevant mental health problems. The main reasons for presenting to the acute psychiatric emergency service were suicidal ideation and/or behaviour (60%). The most frequent diagnosis given at the initial evaluation was ICD-10 F43.9 "reaction to severe stress, unspecified" (50%). Evaluations were made primarily by non-psychiatrists. No standardized screening or diagnostic instrument was used.CONCLUSION: This first description of the use of an acute psychiatric emergency service by asylum seekers in Denmark shows some of the acute mental health needs asylum seekers present with. The findings of high levels of suicidal ideation and possible diagnostic difficulties are discussed, as well as possible improvements of the referral and psychiatric evaluation processes.

Panic disorder is characterized by the spontaneous and unexpected occurrence of panic attacks. During panic attacks, patients (pts) refer to the Emergency Department (ED). The diagnostic work-up for any panic attack is expensive since symptoms at presentation mimic other diseases such acute coronary syndrome or neurological emergencies. The aim of the present study was to describe a 10 years cohort of pts diagnosed with panic disorder in the ED in terms of ED visit recurrence.

X, 177p., ill., De plus en plus d’enfants et d’adolescents ont besoin d’une aide psychiatrique en urgence. La meilleure manière de fournir cette aide est d’utiliser une approche intégrée sans créer des structures séparées, estime le Centre fédéral d’expertise des soins de santé (KCE), dans une étude menée en collaboration avec l’Université d’Anvers. La Belgique aurait besoin de 15 entités structurées de manière intégrée pour assurer cette aide, avec au moins une par province. Cette aide d’urgence doit être disponible à tout moment et de préférence apportée de manière aussi proche que possible du milieu de vie de l’enfant ou de l’adolescent.

60 p., ill.

X, 177p., ill., Steeds meer kinderen en jongeren hebben dringende psychiatrische hulp nodig. Deze hulp kan het beste worden gegeven via een geïntegreerde aanpak,en niet door aparte afdelingen, stelt het Federaal Kenniscentrum voor de Gezondheidszorg (KCE). Het KCE onderzocht samen met Universiteit Antwerpen de problematiek. België heeft behoefte aan 15 geïntegreerde functies, minstens 1 per provincie. De noodhulp moet op elk moment beschikbaar zijn en wordt bij voorkeur gegeven binnen de leefomgeving van de minderjarige.

In an open study relating psychiatric emergencies in a general hospital, the authors observe that only in 30% of cases does the reason for emergency referral of patients by their general practitioner involve the concept of danger. In view of the results of this study, it would seem beneficial, if one wishes to reduce the number of psychiatric admissions, to improve the training of general practitioners in general psychiatry and in the treatment of mood disorders in particular.

A sample of 755 psychiatric emergencies taken in charge in the emergency service of the St-Luc Hospital, Brussels, was divided into two groups: patients without psychiatric background (498) and patients having received previous psychiatric care (238). A background of psychiatric follow-up strongly influence the taking on and therapeutic decisions to be made by psychiatrists: its absence protects the patient and is seen as the guaranty of a good investment from the therapist while the existence of previous psychiatric treatment rather leads to hospital in lieu of crisis intervention, even when the crisis mechanisms are not significantly different in both samples.