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Biomedical subjects

S C McCann

Publications and source records attributed to S C McCann.

3 recordsLinked to original sources

Characteristics of psychiatric emergency room patients with alcohol- or drug-induced disorders.

Although emergency room psychiatrists are often faced with evaluating and planning treatment for patients who abuse substances, there is limited information about the characteristics of emergency room patients with alcohol- or drug-induced disorders. The authors describe the demographic and clinical characteristics of 343 consecutive patients referred to a general hospital's emergency psychiatry service. The 114 patients diagnosed as having an alcohol- or drug-induced disorder were younger and were more often male, unemployed, and homeless than patients with disorders not induced by substance abuse. They also demonstrated increased suicidality. Alcohol was the predominant substance that contributed to psychiatric emergencies, but a surprising number of patients were diagnosed as having amphetamine-induced disorders, possibly representing an important trend.

Adult↗

Underdiagnosis of psychoactive-substance-induced organic mental disorders in emergency psychiatry.

The tendency of emergency psychiatrists to make alcohol- and drug-related diagnoses was examined before and after the addition of a standardized psychoactive substance use questionnaire. The addition of the questionnaire resulted in a significant increase in the number of psychoactive-substance-induced organic mental disorder (substance-induced disorder) diagnoses. The questionnaire selectively increased the recognition of nonalcoholic substance-induced disorders while not significantly increasing the diagnoses of alcohol-induced disorders when alcohol was used alone. This suggests that nonalcoholic substance-induced disorders are underdiagnosed in emergency psychiatry. With the increase in the diagnoses of substance-induced disorders, there was a significant decrease in the frequency of psychotic disorder diagnoses and a significant increase in the frequency of adjustment disorder diagnoses. The clinical impact of underdiagnosing and misdiagnosing substance-induced disorders is discussed. Overall, the findings suggest that an increased awareness of substance use history, by the use of a standardized questionnaire, is an effective means of increasing the diagnostic yield of substance-induced disorders in the psychiatric emergency room. Follow-up studies using urine drug screening are recommended.

Diagnosis, Differential↗