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

Study Overview
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Brief Summary
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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.

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

Conditions
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Psychiatric Disorder, Neurologic Disorder

Intervention / Treatment
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* Other: Screening for acute confusional state


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| psychiatric diagnosis<br>psychiatric diagnosis : patients who were given a psychiatric diagnosis at the end of the follow up | Other: Screening for acute confusional state<br>* The intervention will consist of two psychometric test to screen for acute confusional state with the usual physical examination by the emergency physician. The neurological examination abnormalities will be noted<br>|
| somatic diagnosis<br>somatic diagnosis: patients who were given a somatic diagnosis at the end of the follow up | Other: Screening for acute confusional state<br>* The intervention will consist of two psychometric test to screen for acute confusional state with the usual physical examination by the emergency physician. The neurological examination abnormalities will be noted<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Somatic or psychiatric nature of the final diagnosis given to the patient | interview patient to collect during the last 90 days the data of a hospitalization, its possible duration, the examinations that may have been necessary to obtain the diagnosis: blood, urine, Cerebrospinal Fluid, imaging exams, electroencephalography. | At 3 month |