Psychiatric Emergency Referral in a Teaching Hospital in Kathmandu Valley

Abstract

Introduction: Emergency service of general hospital is the main entry point to various departments.
Psychiatric emergencies may include violence, agitation, suicide, substance dependence, panic
attacks, and delusional disorder. In Nepal, there is a paucity of data. Hence, we carried out this
study to find the pattern of psychiatry morbidity related demographic variables, reason for referral,
source of referral and presenting complaints to emergency services.
Methods: A cross- sectional study among 118 patients attending Emergency services of Kist
Medical College, who were referred for psychiatric consultation were enrolled. The study period
was 15th April to 15th June 2019. Semi-structured Performa was used to collect socio-demographic
profiles, reason of referral, source of referral of the patients and diagnosis was made based on
ICD 10 criteria. Data was tabulated using MS excel and analyzed using SPSS-16 version.
Results: Out of 118 patients 33.9% patients were in the age group of 19-30 years. Most of
the subjects were male (63.6%), married (66.1%) and Hindu (75.4%) by religion. Majority of the
patients were from valley (61.0%. Most of them were students (24.6%) and housewife (24.6%).
The most common diagnosis was Mania. Majority of them were referred by other hospital (46.6%)
and reason of referral was presence of prominent psychiatric symptoms (67.8%).
Conclusion: The most common psychiatric disorder was Mania. Majority of the patients were
referred by other hospitals and the reason of referral was presence of prominent psychiatric
symptoms. The most common presenting complaints were aggressive behavior.
Keywords: Emergency, psychiatry, referral