Agitation and Psychiatric Disease
Best Practices for Emergency Care
Scientific Insights into Agitation Pathophysiology
Delirium: a neurologist's view—the neurology of agitation and overactivity.
Caplan LR. Rev Neurol Dis. 2010;7:111-118.
Heisenberg in the ER: observation appears to reduce involuntary intramuscular injections in a psychiatric emergency service.
Damsa C, et al. Gen Hosp Psychiatry. 2006;28(5):431-433.
Alternative delivery systems for agents to treat acute agitation: progress to date.
Nordstrom K, Allen MH. Drugs. 2013;73:1783-1792.
The neurobiology of the switch process in bipolar disorder: a review.
Salvadore G, et al. J Clin Psychiatry. 2010;71(11):1488-1501.
Schizophrenia: a systematic review of the disease state, current therapeutics and their molecular mechanisms of action.
Shin JK, et al. Curr Med Chem. 2011;18(9):1380-1404.
A national study of violent behavior in persons with schizophrenia.
Swanson JW, et al. Arch Gen Psych. 2006;63(5):490-499.
The assessment and management of the violent patient in critical hospital settings.
Tischler CL, et al. Gen Hosp Psychiatry. 2013;35(2):181-185.
Clinical Assessment Tools
Behavioral Activity Rating Scale (BARS)
The BARS allows for a quick assessment of agitation via a numerical rating score of 1 to 7.
Overt Agitation Severity Scale (OASS)
Designed to assess agitation, this comprehensive evaluation scale relies on the observation of specific agitation-related behaviors and the frequencies at which they manifest.
Positive and Negative Syndrome Scale, Excited Component (PANSS-EC)
This subscale of the Positive and Negative Syndrome Scale specifically evaluates excited states by assessing patients for 5 items: poor impulse control, tension, hostility, uncooperativeness, and excitement.
American Association for Emergency Psychiatry Project BETA Guidelines:
Use and avoidance of seclusion and restraint: consensus statement of the American Association for Emergency Psychiatry Project BETA Seclusion and Restraint Workgroup.
Knox DK, Holloman GH, Jr. West J Emerg Med. 2012;13(1)35-40.
Medical evaluation and triage of the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BETA Medical Evaluation Workgroup.
Nordstrom K, et al. West J Emerg Med. 2012;13(1):3-10.
Verbal de-escalation of the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup.
Richmond JS, et al. West J Emerg Med. 2012;13(1):17-25.
Psychiatric evaluation of the agitated patient: consensus statement of the American Association for Emergency Psychiatry Project BETA Psychiatric Evaluation Workgroup.
Stowell KR, et al. West J Emerg Med. 2012;13(1):11-16.
The psychopharmacology of agitation: consensus statement of the American Association for Emergency Psychiatry Project BETA Psychopharmacology Workgroup.
Wilson MP, et al. West J Emerg Med. 2012;13(1):26-34.
Agitation and Psychiatric Disease
Best Practices for Emergency Care
| Faculty: | Michael H. Allen, MD; Leslie Citrome, MD, MPH; Kimberly Nordstrom, MD, JD |
| Release: | 03/17/2016 |
| Expiration: | 03/16/2017 |
