Riv Psichiatr. 2016 Nov-Dec;51(6):238-250. doi: 10.1708/2596.26724.
Psychomotor agitation (PMA) is a heterogeneous clinical syndrome associated with a widenumber of pathological conditions. The currently available recommendations and guidelines on PMA correct assessment and management are significantly dishomogeneous and suffer from a lack of standardization, especially regarding pharmacological interventions. Based on this deficiency, and on multidisciplinary nature of PMA, that includes factors shared by different health professionals other than pharmacoeconomic and risk management aspects, we started a project aimed to elaborate a shared model of integrated management for PMA patients. The model, developed by a scientific board and a multidisciplinary panel using the consensus Delphi-RAND method, aims to give indications of good clinical practice for the management of these patients. The present document reports the results of this consensus process, whose main principles are the centrality of the patient, as an active and collaborating subject, the importance of prompt and not coercive interventions able to block the escalation to violence and to allow a correct diagnostic and therapeutic workup, the appropriate use of pharmacological interventions based on the severity of symptoms and the importance of an integrated and harmonized approach by the different professionals involved in PMA management.
精神运动性激越（PMA）是一种与多种病理状况相关的异质性临床综合征。目前关于PMA正确评估和管理的建议及指南存在显著差异，且缺乏标准化，尤其是在药物干预方面。基于这一缺陷以及PMA的多学科性质（其中包括除药物经济学和风险管理方面外不同卫生专业人员共有的因素），我们启动了一个项目，旨在为PMA患者精心制定一个综合管理的共享模型。该模型由一个科学委员会和一个多学科小组采用德尔菲 - 兰德共识法开发，旨在为这些患者的管理提供良好临床实践的指导。本文件报告了这一共识过程的结果，其主要原则包括：患者作为积极协作主体的核心地位；能够阻止激越升级为暴力行为并允许进行正确诊断和治疗检查的及时且非强制性干预措施的重要性；根据症状严重程度适当使用药物干预；以及参与PMA管理的不同专业人员采用综合协调方法的重要性。
