Emergency in Psychiatry – The Various Facets of Behavioral Emergencies, Crises and Suicidality

Psychiatric emergencies occur every day in various presentations, and in various clinical settings. General practitioners, social workers, relatives and teachers are challenged with crises of their patients and beloved that makes them stunned, overwhelmed and helpless. But, professionals in the field of psychiatry and emergency medicine also struggle sometimes finding the best solution for the complex situations people with psychiatric emergencies can be. Indeed, individual psychopathology and biological processes that contribute to increased suicidality are still controversially discussed. Psychiatrists themselves are occasionally uncertain whether antidepressants do increase suicide risk in patients instead of protecting their life. On the other hand, even highly protecting settings like in forensic units are still confronted with high suicide rates. Further, management of crises and suicidality in the context of major depression, dementia or psychosis may be different to crises, non-suicidal self-injury or suicidality we are faced in adolescents or patients with personality disorder. Notwithstanding that especially the latter frequently present with emotional or suicidal crises, they are rarely satisfied with the help they get from their counterpart or may even have untoward consequences that make the situation for the patient more difficult in the long run (e.g., repeated hospitalizations, feeling of insufficiency, discontinuation of psychotherapy).

Comprising of original research articles, brief research reports, clinical trials, case reports, reviews, mini-reviews and perspectives, the collection of this Research Topic aims to compile what is behind psychiatric emergencies and suicidality in their various clinical presentations, adding to a better understanding of the individual patient’s motives and need. Specific aspects in forensic, geriatric or child and adolescent settings are presented. We discuss the cross-diagnostic neurobiological background of suicidality, as well as psychological functions of recurrent self-injury or suicide attempts in personality disorder and other mental disorders. Besides from general management and psychopharmacology and recent public mental health and suicide prevention programs, we will discuss possible approaches that may be helpful in families or in psychotherapy.