Identify the type of psychiatric emergency.
The type of psychiatric emergency displayed by the patient is the psychomotor agitation. It is a state of restlessness and tension that is usually accompanied by increased agitation and risks of violence (Heath et al., 2018). Such patients show signs of anger and the inability to remain still.
What diagnostic/laboratory work/screening tool will be necessary to confirm a diagnosis of this psychiatric emergency?
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The diagnosis of this psychiatric emergency is majorly made through physical observation of the symptoms. Symptoms such as increased violence and agitation, restlessness, and emotional distress can be associated with psychomotor agitation (Vieta et al., 2017). However, laboratory screening can also be conducted for heart rate or blood pressure to ascertain the condition.
What indicators helped you identify the likely diagnosis of this psychiatric emergency?
Psychomotor agitation is usually associated with increased risks of violence, irritability, restlessness, and emotional distress. It comes with anxiety, tension, and inability to settle. The patient can also experience sleeplessness due to high levels of anxiety (San et al., 2016). The 26-year old patient showed signs of aggression, especially by punching a friend. The patient showed all the signs and behaviors associated with the condition.
Based on this, state the recommended treatment.
A combination of therapy and medication can best help in the treatment of the condition. Drug prescriptions, such as mood stabilizers and antipsychotics, can help reduce agitation and promote calmness (Iwanami et al., 2015). However, this needs to be accompanied by therapy sessions with a psychiatrist.
What follow up strategies and recommendations will be necessary for this patient?
After discharge, the patient will be required to visit the facility every seven days for the next month to monitor the recovery progress. The patient will have to get a strong therapeutic alliance with the psychiatrist to help in the monitoring and management of the symptoms. During the follow up after hospitalization, the goal will be to help the patient achieve calmness and ascertain that he is responding positively to medication and therapy.
State the necessary changes to the treatment plan
A change in the treatment plan is necessary when the initially provided medications are not being effective in treating signs. Due to the patient's high rate of agitation, the treatment plan will be changed to include evidence-based pharmacological options. The plan will need to include verbal de-escalation during the therapy sessions to manage the agitation episodes. The treatment plan can also be changed to increase the frequency of the follow up from once to thrice a week. The action will help establish the needed therapeutic relationship with the patient. The patient will visit the facility thrice a week, where the progress will be monitored.
References
Heath, A., Lindberg, D. R., Makowiecki, K., Gray, A., Asp, A. J., Rodger, J., ... & Croarkin, P. E. (2018). Medium-and high-intensity rTMS reduces psychomotor agitation with distinct neurobiological mechanisms. Translational psychiatry , 8 (1), 1-13.
Iwanami, T., Maeshima, H., Baba, H., Satomura, E., Namekawa, Y., Shimano, T., ... & Arai, H. (2015). Psychomotor agitation in major depressive disorder is a predictive factor of mood-switching. Journal of affective disorders , 170 , 185-189.
San, L., Marksteiner, J., Zwanzger, P., Figueroa, M. A., Romero, F. T., Kyropoulos, G., ... & Boldeanu, A. (2016). State of acute agitation at psychiatric emergencies in Europe: the STAGE study. Clinical practice and epidemiology in mental health: CP & EMH , 12 , 75.
Vieta i Pascual, E., Garriga, M., Cardete Morales, L., Bernardo Arroyo, M., Lombraña, M., Blanch Andreu, J., ... & Martínez-Arán, A. (2017). Protocol for the management of psychiatric patients with psychomotor agitation. BMC Psychiatry, 2017, vol. 17, num. 328 .
