Assessment and management of agitation in psychiatry: Expert consensus.

نویسندگان

  • Marina Garriga
  • Isabella Pacchiarotti
  • Siegfried Kasper
  • Scott L Zeller
  • Michael H Allen
  • Gustavo Vázquez
  • Leonardo Baldaçara
  • Luis San
  • R Hamish McAllister-Williams
  • Konstantinos N Fountoulakis
  • Philippe Courtet
  • Dieter Naber
  • Esther W Chan
  • Andrea Fagiolini
  • Hans Jürgen Möller
  • Heinz Grunze
  • Pierre Michel Llorca
  • Richard L Jaffe
  • Lakshmi N Yatham
  • Diego Hidalgo-Mazzei
  • Marc Passamar
  • Thomas Messer
  • Miquel Bernardo
  • Eduard Vieta
چکیده

BACKGROUND Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry. Current recommendations on agitation in psychiatry are not univocal. Actually, an improper assessment and management may result in unnecessary coercive or sedative treatments. A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions. METHODS An expert task force iteratively developed consensus using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new, re-worded or re-rated items. RESULTS Out of 2175 papers assessing psychomotor agitation, 124 were included in the review. Each component was assigned a level of evidence. Integrating the evidence and the experience of the task force members, a consensus was reached on 22 statements on this topic. CONCLUSIONS Recommendations on the assessment of agitation emphasise the importance of identifying any possible medical cause. For its management, experts agreed in considering verbal de-escalation and environmental modification techniques as first choice, considering physical restraint as a last resort strategy. Regarding pharmacological treatment, the "ideal" medication should calm without over-sedate. Generally, oral or inhaled formulations should be preferred over i.m. routes in mildly agitated patients. Intravenous treatments should be avoided.

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عنوان ژورنال:
  • The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry

دوره 17 2  شماره 

صفحات  -

تاریخ انتشار 2016