Factors predicting the presence of impaired clinical insight in liaison psychiatric patients assessed in the Emergency Room

Abstract

Objectives: There are limited studies on the factors that can predict the presence of impaired clinical insight specifically in an Emergency Room (ER) psychiatric patient population. The objective of this study is to examine the factors that can predict the likelihood that a patient presenting to the ER will have impaired clinical insight. Methods: Nineteen independent demographic and clinical factors contained on data assessment tools for 337 patients assessed by the crisis team in the ER over 6 months were compiled and analysed using SPSS Version 20 with univariate analyses and logistic regression. Results: Patients who were unemployed or had a history of self-harm or had psychotic symptoms on mental state examination were about two, three and six times, respectively, more likely to have impaired clinical insight compared with those who were employed, had no history of self-harm or had no psychotic symptoms on mental state examination, controlling for other factors in the logistic regression model. Conclusion: Patients who are unemployed, have a history of self-harm or have psychotic symptoms following as psychiatric assessment in the ER may benefit from an insight-oriented psychotherapy.

Keywords:

• Clinical insight
• emergency room
• impaired
• patients
• psychiatric

Acknowledgements

The author will like to thank Aisling Kavanagh and Lotta Shandalla, crisis nurses at the Northern Lights Regional Health Centre, who facilitated data collection and inputting of data into SPSS.

Declaration of interest

The author reports no conflicts of interest. The author alone is responsible for the content and writing of this article.