Abstract

ANALYSING PROFILES: AN AUDIT ON PATIENT CHARACTERISTICS AND OUTCOMES IN THE ONLY PSYCHIATRIC INTENSIVE CARE UNIT (PICU) IN SINGAPORE.

Objective: The High Dependency Psychiatric Care Unit (HDPCU) at the The Institute of Mental Health, Singapore is the only psychiatric intensive care unit (PICU) in Singapore. The HDPCU provides care for severely disturbed patients and patients who pose risks which the general psychiatric wards are unable to handle. There have been no published studies on the characteristics and outcomes of patients admitted for psychiatric intensive care in Singapore. The primary aim of our audit was to understand the characteristics and outcomes of patients admitted to the HDPCU. Our secondary aim was to examine the differences in characteristics and outcomes between patients who were directly admitted to the HDPCU from the emergency room and those who were transferred to the HDPCU from the general psychiatric wards.

Methods: Data was collected from electronic case notes and the HDPCU database, for all patients who were admitted to the HDPCU from January 2015 to December 2015. Patient demographics and clinical characteristics were collect for all HDPCU patients and compared for patients directly admitted to the HDPCU and patients who were transferred from the general wards.

Results: The most common primary diagnosis was that of schizophrenia, followed by bipolar disorder. The main reason for transfer to the HDPCU was because of disturbed, agitated and violent behaviour. Dynamic Appraisal of Situational Aggression (DASA) scores, Clinical Global Impression – Severity scale (CGI-S) scores and the 18 item Brief Psychiatric Rating Scale (BPRS) scores were all significantly reduced. Patients who were directly admitted to the HDPCU had a significantly shorter duration of hospitalisation and stay in the HDPCU.

Conclusion: The HDPCU can deliver effective treatment, however further research needs to be done to determine predictors of HDPCU admissions.