• Paraskevi Mavrogiorgou, Martin Brüne, and Georg Juckel.
• Klinik für Psychiatrie, Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum der Ruhr-Universität Bochum.
• Dtsch Arztebl Int. 2011 Apr 1; 108 (13): 222230222-30.

BackgroundPsychiatric emergencies such as acute psychomotor agitation or suicidality often arise in non-psychiatric settings such as general hospitals, emergency services, or doctors' offices and give rise to stress for all persons involved. They may be life-threatening and must therefore be treated at once. In this article, we discuss the main presenting features, differential diagnoses, and treatment options for the main types of psychiatric emergency, as an aid to their rapid and effective management.MethodSelective literature review.Results And ConclusionThe frequency of psychiatric emergencies in non-psychiatric settings, such as general hospitals and doctors' offices, and their treatment are poorly documented by the few controlled studies and sparse reliable data that are now available. The existing evidence suggests that the diagnosis and treatment of psychiatric emergencies need improvement. The treatment of such cases places high demands on the physician's personality and conduct, aside from requiring relevant medical expertise. Essential components of successful treatment include the establishment of a stable, trusting relationship with the patient and the ability to "talk down" agitated patients calmly and patiently. A rapid and unambiguous decision about treatment, including consideration of the available options for effective pharmacotherapy, usually swiftly improves the acute manifestations.

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