Observatory of Psychiatric Symptoms and Their Somatic Causes in Urgent Medical Care

Observatory of Psychiatric Symptoms and Their Somatic Causes in Urgent Medical Care (OPOSSUM)

Use of emergency department for psychiatric symptoms always addresses the question of a potential somatic cause to the symptoms. Despite the wide-spread use of standard biology test and systematic brain imaging (for a first episode), there are still up to 5% of patients sent in psychiatric wards that actually have a somatic explanation to their symptoms which induces an important delay in the diagnostic assessement We hypothesized that simple neurological clinical examination along with fast psychometric screening tests in the Emergency Room (ER) could help the physicians to better screen the patients and thus prevent inaccurate post-emergency orientation.

Every patient visiting the ER for psychiatric symptoms will be included. The usual physical examination by the ER physician will be associated with two psychometric tests (namely the Clock-drawing test and Frontal Assessment Battery test).

The follow up will be made after 3 months in order to have the final diagnosis. Neurological data and data from the FAB test and the Clock-drawing test will be compared between patients who were finally given a psychiatric diagnosis versus patients with a somatic diagnosis at the end of the follow up period.

Inclusion Criteria:

• Age> 18 years old
• Patient consulting the emergency room for psychiatric recourse
• Benefiting from a consultation with a psychiatrist in the emergency room
• Patient affiliated to a social security scheme

Exclusion Criteria:

• Pregnant or breastfeeding women
• Patient objecting to the conduct of this study and the collection of health data
• Patient with motor disorders preventing the performance of a test requiring a pencil
• Patient sedated before treatment in the emergency room
• Patient with visual disturbances