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

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.

Study Overview

• Status: Completed
• Conditions: Neurologic Disorder; Psychiatric Disorder
• Intervention / Treatment: Other: Screening for acute confusional state

• Study Type: Observational
• Enrollment (Actual): 148

Contacts and Locations

Study Locations

• France
  • Rhône
    • Lyon, Rhône, France, 69003
      • Service Accueil des Urgences, Hopital Edouard Herriot

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patient using emergency department for a psychiatric symptom

Description

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

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
psychiatric diagnosis; psychiatric diagnosis : patients who were given a psychiatric diagnosis at the end of the follow up	Other: Screening for acute confusional state; 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
somatic diagnosis; somatic diagnosis: patients who were given a somatic diagnosis at the end of the follow up	Other: Screening for acute confusional state; 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

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Hospices Civils de Lyon
• Investigators: Principal Investigator: KARIM TAZAROURTE, MD, PhD, Hôpital Edouard Herriot, HCL

Study record dates

Study Major Dates

• Study Start (Actual): May 11, 2021
• Primary Completion (Actual): May 8, 2024
• Study Completion (Actual): May 8, 2024

Study Registration Dates

• First Submitted: January 22, 2021
• First Submitted That Met QC Criteria: January 22, 2021
• First Posted (Actual): January 27, 2021

Study Record Updates

• Last Update Posted (Actual): June 7, 2024
• Last Update Submitted That Met QC Criteria: June 6, 2024
• Last Verified: July 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Problem Behavior; Mental Disorders; Nervous System Diseases
• Other Study ID Numbers: 69HCL20_1071

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No