Emergency Psychiatric Referrals to the Casualty Department of a General Hospital

Abstract

A survey of 100 consecutive cases referred as psychiatric emergencies to the casualty department of a general hospital is reported. Cases of self-poisoning recognised by the casualty officers were not included. Fifty-seven of the patients were self-referred. Significant excesses were found in the sample of men in social classes IV and V, and men and women in 30 to 49 years age group. The commonest diagnoses were manic-depressive psychosis (38 per cent) and chronic alcoholism (27 per cent). The risk of suicide was considered to be high. Psychiatric referrals to the casualty department are increasing. Many patients claimed poor relationships with their general practitioners. The preventive function of a psychiatric unit in a general hospital is stressed. It is suggested a psychiatric casualty service may be needed in each big city.