Ouarad G, Lapostolle F, Linval F, Petrovic T, Laghmari N, Goix L, Adnet F, Reuter P-G
SAMU 93-UF Recherche, AP-HP, hôpital Avicenne, 93000 Bobigny, France.
SAMU 93-UF Recherche, AP-HP, hôpital Avicenne, 93000 Bobigny, France; SAMU 92, AP-HP, hôpital Raymond-Poincaré, 92380 Garches, France.
Encephale. 2022 Jun;48(3):273-279. doi: 10.1016/j.encep.2021.02.022. Epub 2021 Jun 18.
Involuntary psychiatric hospitalization (IPH) is a heavy and complex psychiatric exception measure. In the Seine-Saint-Denis department (low medical density), the evaluation of the patient in psychiatric decompensation is the responsibility of the out-of-hours general practitioners (GP) mandated by the call center. Their feeling is the non-achievement of the procedure once the patient arrives at the emergency room. We aimed to evaluate the outcome of patients following a request for IPH from these GP.
We conducted a retrospective study based on all requests for IPH received during 2016 at the Seine-Saint-Denis emergency medical call center. The characteristics of the call and the patient, as well as the decisions of the regulator and the GP were collected. The decision of hospitalization in the emergency room was sought for patients referred for IPH.
Of the 7541 calls for decompensation, 539 were for an IPH. These calls occurred during non-working hours in 55 % of cases. A GP was involved in more than two-thirds of the cases and requested an IPH for 240/304 (79 %) patients. Patients were male in 56 % of cases with an average age of 40 (±16) years. IPH was confirmed for 132 (61 %) patients. This rate did not differ from the 65 % reported in the literature (Z-test, P=0.26). Voluntary hospitalization was performed for 37 (17 %) other patients.
The IPH rate for patients referred by GP mandated by the call center was comparable to that following the requests of the attending physicians, validating their intervention in this critical context.
非自愿精神科住院治疗（IPH）是一项繁重且复杂的精神科特殊措施。在塞纳 - 圣但尼省（医疗资源密度较低），对精神失代偿患者的评估由呼叫中心指定的非工作时间全科医生（GP）负责。他们感觉患者一旦抵达急诊室，整个流程就未完成。我们旨在评估这些全科医生提出IPH请求后患者的治疗结果。
我们基于2016年在塞纳 - 圣但尼省紧急医疗呼叫中心收到的所有IPH请求进行了一项回顾性研究。收集了呼叫及患者的特征，以及监管者和全科医生的决策。对于被转诊进行IPH的患者，我们查询了其在急诊室的住院决策。
在7541次失代偿呼叫中，有539次是关于IPH的。这些呼叫在55%的情况下发生在非工作时间。超过三分之二的案例涉及一名全科医生，该医生为240/304（79%）的患者请求了IPH。56%的案例中患者为男性，平均年龄40（±16）岁·。132（61%）名患者的IPH得到确认。该比率与文献报道的65%无差异（Z检验，P = 0.26）。另外37（17%）名患者接受了自愿住院治疗。
由呼叫中心指定的全科医生转诊的患者的IPH比率与主治医生提出请求后的比率相当，证实了他们在这一关键情况下的干预效果。
