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Häufigkeit von psychiatrischen Diagnosen in der retrospektiven Untersuchung von Notarztpatienten

Occurrence of psychiatric diagnosis in physician conducted emergency medicine: A retrospective study

  • ORIGINALARBEIT
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Intensivmedizin und Notfallmedizin

Summary

Objective

There are different data on the frequency of psychiatric diagnosis in emergency medicine. The reported data range from 3 to 10% based on the records of the emergency physicians. Studies in GPs’ primary care showed a psychiatric diagnosis in more than 40% of patients.

Question

Is it possible to find better data of psychiatric diagnosis in emergency medicine using a special psychiatric instrument (patient health questionnaire, PHQ)?

Methods

A total of 169 patients of an emergency medical service in Germany were asked about their psychopathologic condition using PHQ. We made a comparison of these data with the records written by the emergency physicians.

Results

In all 48 records could be used in the complete analysis. Findings of psychiatric distinctive features were 53.6% (male) and 65.0% (female) respectively. In detail, rates for depression were 32.1% (male) and 55.0% (female), rates for panic disorder were 21.4% (m) and 50.0% (f), and for anxiety 14.3% (m) and 50.0% (f).

Discussion

A psychiatric diagnostic instrument could be useful when diagnosing psychiatric basics of emergency medical patients. It could be helpful for economical use of resources.

Zusammenfassung

Einleitung

Die Häufigkeit von Patienten mit psychiatrischen Diagnosen und ihre Relevanz im Notarztdienst ist umstritten. Die veröffentlichten Zahlen bewegen sich zwischen 3 und 11%. Als Basis solcher Auswertungen dienten bislang die Angaben der Notärzte im Einsatzprotokoll. In Allgemeinarztpraxen finden sich bei geeigneter Untersuchungstechnik dagegen bei bis zu 40% der akut vorgestellten Patienten eine relevante psychiatrische Störung.

Fragestellung

Lassen sich durch Einsatz eines Untersuchungsinstrumentes (Patient Health Questionnaire, PHQ) neue Daten zu Häufigkeit und Bedeutung psychiatrischer Diagnosen im Notarztdienst erheben?

Methodik

169 Notarztpatienten wurden bezüglich psychiatrischer (Co-)Diagnosen mittels PHQ retrospektiv befragt und die Ergebnisse mit den Angaben auf dem Notarzteinsatzprotokollen verglichen.

Ergebnisse

Bei 48 Patienten konnten die Antworten ausgewertet werden. Es fanden sich bei 53,6% der Männer und 65,0% der Frauen Hinweise auf das Vorliegen einer oder mehrerer psychiatrischer Erkrankungen.

Diskussion

Die erhobenen Zahlen weichen deutlich von den epidemiologischen Angaben ab, die aufgrund der Notarzteinsatzprotokolle bislang veröffentlicht wurden. Der Gebrauch eines diagnostischen Instrumentes wie es der PHQ darstellt, kann auch dem psychiatrisch wenig Erfahrenen helfen, wenig offensichtliche psychiatrische (Co-)Diagnosen zu detektieren. In der Notfallmedizin lassen sich dadurch Ressourcen möglicherweise optimaler nutzen.

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Tonn, P., Gerlach, N., Reuter, S. et al. Häufigkeit von psychiatrischen Diagnosen in der retrospektiven Untersuchung von Notarztpatienten. Intensivmed 43, 123–129 (2006). https://doi.org/10.1007/s00390-006-0650-0

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  • DOI: https://doi.org/10.1007/s00390-006-0650-0

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