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Yıl:2012; Cilt: 2; Sayı: 2>> Özet
Güncel Psikiyatri ve Psikonörofarmakoloji; 2012;2(2):9-15
Acilci Gözüyle Psikiyatrik Aciller
MA Karamercan
Ankara Eğitim ve Araştırma Hastanesi Acil Tıp Kliniği Altındağ/ANKARA
Psikiyatrik aciller medikal acillerin önemli bir kısmını oluşturmakta ve psikiyatrik acil olarak acil servislere
başvuran hastaların sayısında ciddi bir artış bulunmaktadır. Medikal ve psikiyatrik hastalığı birlikte bulunan
hastaların değerlendirilmesi ve tedavisi çok zor olabilir. Psikiyatrik hastalarda bulunan medikal acillerin geç
tanınması veya saptanmaması hasta ölümü dahil olmak üzere kötü sonuçlara sebep olabilir. Psikomotor
ajitasyon veya özkıyım girişimleri gibi psikiyatrik aciller psikiyatri kliniklerinden ziyade sıklıkla acil servislerde
görülmektedir. Psikiyatrik semptomlarla başvuran hastaların ayırıcı tanısında enfeksiyonlar, metabolik bozukluklar,
endokrin anormallikleri, medikasyonlar, madde kötüye kullanımı ve santral sinir sistemi hastalıkları gibi
birçok medikal hastalık mevcuttur. Medikal hastalıkların psikiyatrik hastalık olarak yanlış tanı konulmasına ve
psikiyatrik hastalıkların yanlış tedavi edilmesine bağlı mortalite ve morbiditenin önlenmesi için acil servislerde
uygun değerlendirme ve tedavi şarttır. Bu makalede, psikiyatrik acillerde organik rahatsızlıkların hızlı
ve etkin yönetimine yardımcı olmak için; psikiyatrik acillerde görülen organik rahatsızlıkların temel başvuru
özellikleri, ayırıcı tanıları ve tedavi seçenekleri tartışılacaktır.
Psychiatric Emergencies From Perspective of an Emergency Specialist
Psychiatric emergencies constitute an important component of medical emergencies and there has been a significant increase in the number
of patients with psychiatric emergencies seeking treatment in the emergency departments. Patients with co-existing medical and psychiatric
diagnoses can be challenging to assess and treat. Medical emergencies among psychiatric patients may receive delayed medical responses
or remain undetected, leading to negative patient outcomes, including death. Psychiatric emergencies such as acute psychomotor agitation
or suicidality often arise in emergency services instead of psychiatry clinics. The differential diagnosis of medical conditions presenting with
psychiatric symptoms is broad and includes infections, metabolic derangements, endocrine abnormalities, medications, substance abuse,
and central nervous system disorders. Appropriate assessment and treatment in the emergency department is essential to avoid morbidity
and mortality resulting from misdiagnosis of medical conditions as psychiatric illnesses and from mismanagement of psychiatric illnesses. In this
article, we discuss the main presenting features, differential diagnoses, and treatment options for organic disorders in psychiatric emergencies,
as an aid to their rapid and effective management.

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