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Factors Affecting the Agreement Between Emergency Psychiatrists and General Practitioners Regarding Involuntary Psychiatric Hospitalizations.
Geoffroy, Pierre Alexis; Duhamel, Alain; Behal, Hélène; Zouitina-Lietaert, Nadia; Duthilleul, Julie; Marquette, Louise; Ducrocq, François; Vaiva, Guillaume; Rolland, Benjamin.
Afiliación
  • Geoffroy PA; Inserm, U1144, Paris, F-75006, France; Université Paris Descartes, UMR-S 1144, Paris, F-75006, France.
  • Duhamel A; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144 Paris F-75013, France.
  • Behal H; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France.
  • Zouitina-Lietaert N; Département de Biostatistiques, CHU Lille, Lille, France.
  • Duthilleul J; Département de Biostatistiques, CHU Lille, Lille, France.
  • Marquette L; Service de Psychiatrie de l'adulte, CHU Lille, Lille, France.
  • Ducrocq F; Pôle de l'Urgence, CHU Lille, Lille, France.
  • Vaiva G; Service d'Addictologie, CHU Lille, Lille, France.
  • Rolland B; Pôle de l'Urgence, CHU Lille, Lille, France.
Sci Rep ; 6: 28134, 2016 06 21.
Article en En | MEDLINE | ID: mdl-27324574
Important discrepancies exist between physicians in deciding when to perform involuntary hospitalization measures (IHMs). The factors underlying these differences are poorly known.We conducted a two-year single-center retrospective study in France on patients who were referred to the emergency department (ED) with an IHM certificate written by a private-practice General Practitioner (GP). For each consultation, the official IHM motive was categorized into four groups: Suicide; Psychosis, Mania, or Melancholia (PMM); Agitation; and Other. The alcohol status of the patient was also noted. The factors underlying the ED psychiatrists' confirmation of the use of IHMs were determined using a logistic regression model. One hundred eighty-nine cases were found (165 patients; 44.2 ± 16 years, 41.3% women). The ED psychiatrists confirmed the use of IHMs in 123 instances (65.1% agreement rate). Multivariate analyses found that IHM disagreement was significantly associated with patient alcohol status and the reason for referral. Specifically, there was an increased risk of IHM disagreement when the patient had an alcohol-positive status (OR = 15.80; 95% CI [6.45-38.67]; p < 0.0001) and when the motive for IHM was "agitation" compared with "suicide" (OR = 11.44; 95% CI[3.38-38.78]; p < 0.0001). These findings reflect significant disparities between GPs and ED psychiatrists regarding the decision to proceed to an IHM.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Psiquiatría / Trastornos Psicóticos / Trastorno Bipolar / Trastorno Depresivo / Médicos Generales / Tratamiento Involuntario / Tratamiento Psiquiátrico Involuntario Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Sci Rep Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Psiquiatría / Trastornos Psicóticos / Trastorno Bipolar / Trastorno Depresivo / Médicos Generales / Tratamiento Involuntario / Tratamiento Psiquiátrico Involuntario Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Sci Rep Año: 2016 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Reino Unido