“Possible Depression…” Case Conclusion September 7, 2011
Posted by ebmedicine in Psychiatric & Social Emergencies.add a comment
The Conclusion Is…
After a more detailed psychiatric history and examination, the 28-year-old man admitted having thoughts of hurting himself on and off over the last 3 months and that he has been feeling worse over the last 3 weeks with thoughts increasingly of “drinking himself to death.” In fact, the weekend before, he said he attempted to drink a liter of vodka by himself to “put myself out of my misery.” With this concerning history for possible dysthymia with an overlying major depressive episode history and suicide attempt, psychiatry was consulted and the patient was evaluated for safety. Given his active suicidal ideation and depressed mood, the patient was placed for psychiatric hospitalization. The patient was cooperative and amenable to the plan but given his active suicidal ideation and concern for his wellbeing, the patient was formally sectioned (ie, placed on a temporary involuntary hold).
Congratulations to Dr. Banimahd, Dr. Gozhansky, Dr. Hamdan, Dr. Kietzman, and Dr. Olabode — this week’s winners of Emergency Medicine Practice’s “The Depressed Patient And Suicidal Patient In The Emergency Department: Evidence-Based Management And Treatment Strategies!” For an evidence-based review of risk factors associated with depression and suicide as well as management strategies, read this issue.
Possible Depression… August 24, 2011
Posted by ebmedicine in Psychiatric & Social Emergencies.11 comments
You treat a young man for a URI, but you also find out that he recently moved to the city and states that he is just feeling “overwhelmed” and “sad” and at times thinks he would be “better off dead.” He has never seen a psychiatrist and has never been told by his primary care clinician that he has any sort of psychiatric illness.
Is this person pathologically depressed? Can you diagnose this in the ED? Is this person safe to go home or does he require a psychiatric consultation and possible psychiatric admission?
(Enter to win the latest issue of Emergency Medicine Practice, including CME, by submitting your answers to the questions above. To do so, simply enter your response in the comments box. The deadline to enter is September 6th.)
