emDocs - August 26, 2019 - By Pillai S and Desai S
Edited by: Simon E; Koyfman A; Long B
"Key Points
- 34% to 50% of patients who present to the ED with psychiatric complaints have a coexisting medical illness.
- Situations that favor a substance-induced depressive disorder include: absence of depression history, absence of symptoms prior to substance exposure/intoxication /withdrawal, absence of persistent symptoms following substance use or abuse.
- Seek out an underlying etiology for depression in patients presenting with: new-onset depression with psychotic features, recurrent depression not readily explained by the psycho-social stressors, or treatment-resistant depression.
- Laboratory studies and imaging should be obtained if indicated by history and physical examination.
- Antipsychotics or benzodiazepinesmay be administered to the distressed patient with psychotic features during the ED course.Initiation of outpatient anti-depressant therapy from the ED is not advised."