{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T10:17:03Z","timestamp":1780481823864,"version":"3.54.1"},"reference-count":56,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","emed.theclinics.com","clinicalkey.es","theclinics.com","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Emergency Medicine Clinics of North America"],"published-print":{"date-parts":[[2015,11]]},"DOI":"10.1016\/j.emc.2015.07.002","type":"journal-article","created":{"date-parts":[[2015,9,5]],"date-time":"2015-09-05T01:38:34Z","timestamp":1441417114000},"page":"721-737","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":18,"title":["Down the Rabbit Hole"],"prefix":"10.1016","volume":"33","author":[{"given":"Veronica","family":"Tucci","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaylin","family":"Siever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anu","family":"Matorin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidal","family":"Moukaddam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.emc.2015.07.002_bib1","series-title":"Tintinalli's emergency medicine: a comprehensive study guide","author":"Tintinalli","year":"2011"},{"key":"10.1016\/j.emc.2015.07.002_bib2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1176\/ajp.138.5.629","article-title":"Unrecognized physical illness prompting psychiatric admission: a prospective study","volume":"138","author":"Hall","year":"1981","journal-title":"Am J Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib3","series-title":"APA task force on psychiatric emergency services: report and recommendations regarding psychiatric emergency and crisis services","first-page":"1","author":"Allen","year":"2002"},{"key":"10.1016\/j.emc.2015.07.002_bib4","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1176\/appi.ps.56.6.671","article-title":"Trends in US emergency department visits for mental health conditions, 1992 to 2001","volume":"56","author":"Larkin","year":"2005","journal-title":"Psychiatr Serv"},{"key":"10.1016\/j.emc.2015.07.002_bib5","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1177\/0009922814541806","article-title":"Emergency department visits for mental health conditions among US children, 2001-2011","volume":"53","author":"Simon","year":"2014","journal-title":"Clin Pediatr"},{"key":"10.1016\/j.emc.2015.07.002_bib6","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.annemergmed.2012.01.037","article-title":"Patient- and practice- related determinants of emergency department length of stay for patients with psychiatric illness","volume":"60","author":"Weiss","year":"2012","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib7","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s10597-014-9784-x","article-title":"Hospital readmission rates and emergency department visits for mental health and substance abuse conditions","volume":"51","author":"Smith","year":"2015","journal-title":"Community Ment Health J"},{"key":"10.1016\/j.emc.2015.07.002_bib8","unstructured":"Cherry DK, McCraig LF. Average annual rate of emergency department visits for bipolar disorder among persons aged\u00a0> 15 years by age group\u2013national hospital ambulatory medical care survey, United States, 2010-2011. Available at: www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6349a12.htm."},{"key":"10.1016\/j.emc.2015.07.002_bib9","first-page":"35","article-title":"Treatment of psychiatric patients in emergency settings","volume":"17","author":"Zeller","year":"2010","journal-title":"Prim Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib10","unstructured":"Hakenewerth AM, Tintinalli JE, Waller AE, et\u00a0al. Emergency department visits by patients with mental health disorders\u2013North Carolina, 2008-2010. Available at: www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6223a4.htm."},{"key":"10.1016\/j.emc.2015.07.002_bib11","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.jemermed.2012.01.035","article-title":"Introduction: reconsidering psychiatry in the emergency department","volume":"43","author":"Wilson","year":"2012","journal-title":"J\u00a0Emerg Med"},{"issue":"5","key":"10.1016\/j.emc.2015.07.002_bib12","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1136\/emj.14.5.311","article-title":"An examination of the accident and emergency management of deliberate self harm","volume":"14","author":"Dennis","year":"1997","journal-title":"J\u00a0Accid Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib13","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.jemermed.2012.01.064","article-title":"Pitfalls in the care of the psychiatric patient in the emergency department","volume":"43","author":"Zun","year":"2012","journal-title":"J\u00a0Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib14","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.annemergmed.2006.06.026","article-title":"Survey of California emergency departments about practices for management of suicidal patients and resources available for their care","volume":"48","author":"Baraff","year":"2006","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib15","doi-asserted-by":"crossref","first-page":"E1356","DOI":"10.1542\/peds.2011-0522","article-title":"Technical report\u2013pediatric and adolescent mental health emergencies in the emergency medical services system","volume":"127","author":"Dolan","year":"2011","journal-title":"Pediatrics"},{"key":"10.1016\/j.emc.2015.07.002_bib16","doi-asserted-by":"crossref","first-page":"E40","DOI":"10.1542\/peds.110.4.e40","article-title":"Summary statistics for pediatric visits to US emergency departments, 1993-1999","volume":"110","author":"Sills","year":"2002","journal-title":"Pediatrics"},{"key":"10.1016\/j.emc.2015.07.002_bib17","first-page":"25","article-title":"Evidence-based evaluation of psychiatric patients","volume":"28","author":"Zun","year":"2005","journal-title":"J\u00a0Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib18","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3928\/02793695-20100701-06","article-title":"What does \u201cmedical clearance\u201d for psychiatry really mean?","volume":"48","author":"Reeves","year":"2010","journal-title":"J\u00a0Psychosoc Nurs Ment Health Serv"},{"key":"10.1016\/j.emc.2015.07.002_bib19","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/S0196-0644(94)70326-4","article-title":"Emergency medical evaluation of psychiatric patients","volume":"23","author":"Tintinalli","year":"1994","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib20","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1176\/ajp.136.6.787","article-title":"Emergency room medical clearance: an educational problem","volume":"136","author":"Weissberg","year":"1979","journal-title":"Am J Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib21","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1176\/appi.ajp.2011.11010071","article-title":"Budget impact and sustainability of medical care management for persons with serious mental illness","volume":"168","author":"Druss","year":"2011","journal-title":"Am J Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib22","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1177\/070674370805301107","article-title":"Excess cancer mortality in psychiatric patients","volume":"53","author":"Kisely","year":"2008","journal-title":"Can J Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib23","doi-asserted-by":"crossref","first-page":"E50","DOI":"10.1503\/cmaj.121077","article-title":"Reducing all-cause mortality among patients with psychiatric disorders: a population-based study","volume":"185","author":"Kisely","year":"2013","journal-title":"CMAJ"},{"key":"10.1016\/j.emc.2015.07.002_bib24","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.psychres.2007.07.030","article-title":"Predictors of occupational status six months after hospitalization in persons with a recent onset of psychosis","volume":"160","author":"Dickerson","year":"2008","journal-title":"Psychiatry Res"},{"key":"10.1016\/j.emc.2015.07.002_bib25","series-title":"Psychiatric evaluation of adults, a quick reference guide","first-page":"1","author":"American Psychiatric Association Steering Committee on Practice Guidelines","year":"2006"},{"key":"10.1016\/j.emc.2015.07.002_bib26","series-title":"American Psychiatric Association practice guidelines for the treatment of psychiatric disorders: compendium 2006","author":"American Psychiatric Association","year":"2006"},{"key":"10.1016\/j.emc.2015.07.002_bib27","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.annemergmed.2005.10.002","article-title":"Clinical policy: critical issues in the diagnosis and management of the adult psychiatric patient in the emergency department","volume":"47","author":"Lukens","year":"2006","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib28","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/S0733-8627(05)70117-6","article-title":"Medical clearance of psychiatric patients","volume":"18","author":"Williams","year":"2000","journal-title":"Emerg Med Clin North Am"},{"key":"10.1016\/j.emc.2015.07.002_bib29","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1097\/PEC.0b13e31817de2bb","article-title":"Children\u2019s mental health emergencies-part 2: emergency department evaluation and treatment of children with mental health disorders","volume":"24","author":"Baren","year":"2008","journal-title":"Pediatr Emerg Care"},{"key":"10.1016\/j.emc.2015.07.002_bib30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0733-8627(20)30201-7","article-title":"Evaluation of behavioral and cognitive changes: the mental status examination","volume":"9","author":"Bauer","year":"1991","journal-title":"Emerg Med Clin North Am"},{"key":"10.1016\/j.emc.2015.07.002_bib31","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1001\/archpsyc.1978.01770350041003","article-title":"Physical illness presenting as psychiatric disease","volume":"35","author":"Hall","year":"1978","journal-title":"Arch Gen Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib32","doi-asserted-by":"crossref","first-page":"133","DOI":"10.2190\/PM.39.2.b","article-title":"Factors related to admission of psychiatric patients to medical wards from the general hospital emergency department: a 3-year study of urgent psychiatric consultations","volume":"39","author":"Biancosino","year":"2009","journal-title":"Int J Psychiatry Med"},{"key":"10.1016\/j.emc.2015.07.002_bib33","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1177\/070674378102600114","article-title":"Psychiatric disorders among emergency psychiatric patients","volume":"26","author":"Carlson","year":"1981","journal-title":"Can J Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib34","first-page":"1","article-title":"Behavioral emergencies: differentiating medical from psychiatric disease","volume":"4","author":"Karas","year":"2002","journal-title":"Emerg Med Pract"},{"key":"10.1016\/j.emc.2015.07.002_bib35","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.1.5479.65","article-title":"The \u201cinsanity\u201d of King George III: a classic case of porphyria","volume":"1","author":"Macalpine","year":"1966","journal-title":"Br Med J"},{"key":"10.1016\/j.emc.2015.07.002_bib36","first-page":"26","article-title":"Bipolar disorder: diagnostic challenges and treatment considerations","volume":"61","author":"Evans","year":"2000","journal-title":"J\u00a0Clin Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib37","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0733-8627(20)30207-8","article-title":"Acute psychosis. Functional versus organic","volume":"9","author":"Frame","year":"1991","journal-title":"Emerg Med Clin North Am"},{"key":"10.1016\/j.emc.2015.07.002_bib38","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1016\/S0025-6196(12)62694-9","article-title":"Organic causes of mania","volume":"63","author":"Larson","year":"1988","journal-title":"Mayo Clinic Proc"},{"key":"10.1016\/j.emc.2015.07.002_bib39","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/S0196-0644(94)70277-2","article-title":"Prospective evaluation of the emergency department medical clearance","volume":"24","author":"Henneman","year":"1994","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib40","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1046\/j.1532-5415.2003.51151.x","article-title":"Delirium in older emergency department patients discharged home: effect on survival","volume":"51","author":"Kakuma","year":"2003","journal-title":"J\u00a0Am Geriatr Soc"},{"key":"10.1016\/j.emc.2015.07.002_bib41","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1111\/j.1553-2712.2002.tb02131.x","article-title":"Mental status screening of emergency department patients: normative study of the quick confusion scale","volume":"9","author":"Irons","year":"2002","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib42","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/01.nmd.0000130135.78017.96","article-title":"Comorbidity of medical illness among adults with serious mental illness who are receiving community psychiatric services","volume":"192","author":"Sokal","year":"2004","journal-title":"The J Nervous Ment Dis"},{"key":"10.1016\/j.emc.2015.07.002_bib43","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.emc.2010.03.008","article-title":"The mental status examination in emergency practice","volume":"28","author":"Koita","year":"2010","journal-title":"Emerg Med Clin North Am"},{"key":"10.1016\/j.emc.2015.07.002_bib44","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.genhosppsych.2004.04.006","article-title":"Medical screening in the emergency department for psychiatric admissions: a procedural analysis","volume":"26","author":"Gregory","year":"2004","journal-title":"Gen Hosp Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib45","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jemermed.2007.11.082","article-title":"\u201cMedically cleared\u201d: how well are patients with psychiatric presentations examined by emergency physicians?","volume":"35","author":"Szpakowicz","year":"2008","journal-title":"J\u00a0Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib46","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1053\/ajem.2000.7318","article-title":"Unrecognized medical emergencies admitted to psychiatric units","volume":"4","author":"Reeves","year":"2000","journal-title":"Am J Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib47","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/S0033-3182(90)72134-2","article-title":"Medical clearance: fact or fiction in the hospital emergency room","volume":"30","author":"Riba","year":"1990","journal-title":"Psychosomatics"},{"key":"10.1016\/j.emc.2015.07.002_bib48","first-page":"180","article-title":"Unrecognized physical illness prompting psychiatric admission","volume":"22","author":"Reeves","year":"2010","journal-title":"Ann Clin Psychiatry"},{"key":"10.1016\/j.emc.2015.07.002_bib49","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.jemermed.2010.02.017","article-title":"A\u00a0screening tool to medically clear psychiatric patients in the emergency department","volume":"43","author":"Shah","year":"2012","journal-title":"J\u00a0Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib50","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1001\/jama.1982.03330080046027","article-title":"Diagnostic errors in the evaluation of behavioral disorders","volume":"248","author":"Hoffman","year":"1982","journal-title":"JAMA"},{"key":"10.1016\/j.emc.2015.07.002_bib51","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0736-4679(99)00191-2","article-title":"\u201cMedical clearance\u201d of psychiatric patients without medical complaints in the emergency department","volume":"18","author":"Korn","year":"2000","journal-title":"J\u00a0Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib52","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/j.1553-2712.1997.tb03718.x","article-title":"Medical clearance and screening of psychiatric patients in the emergency department","volume":"4","author":"Olshaker","year":"1997","journal-title":"Acad Emerg Med"},{"issue":"6","key":"10.1016\/j.emc.2015.07.002_bib53","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.annemergmed.2013.10.011","article-title":"Clinical utility of screening laboratory tests in pediatric psychiatric patents presenting to the emergency department for medical clearance","volume":"63","author":"Donofrio","year":"2014","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib54","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/01.pra.0000405369.20538.84","article-title":"The utility and financial implications of obtaining routing laboratory screening upon admission for child and adolescent psychiatric inpatients","volume":"17","author":"Feldman","year":"2011","journal-title":"J\u00a0Psychiatr Pract"},{"key":"10.1016\/j.emc.2015.07.002_bib55","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/j.jemermed.2013.12.003","article-title":"Is medical clearance necessary for pediatric psychiatric patients?","volume":"46","author":"Santillanes","year":"2014","journal-title":"J\u00a0Emerg Med"},{"key":"10.1016\/j.emc.2015.07.002_bib56","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/0163-8343(90)90052-E","article-title":"Cost and utility of routine admission laboratory testing for psychiatric patients","volume":"12","author":"Sheline","year":"1990","journal-title":"Gen Hosp Psychiatry"}],"container-title":["Emergency Medicine Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733862715000553?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0733862715000553?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2022,5,21]],"date-time":"2022-05-21T08:49:28Z","timestamp":1653122968000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0733862715000553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":56,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["S0733862715000553"],"URL":"https:\/\/doi.org\/10.1016\/j.emc.2015.07.002","relation":{},"ISSN":["0733-8627"],"issn-type":[{"value":"0733-8627","type":"print"}],"subject":[],"published":{"date-parts":[[2015,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Down the Rabbit Hole","name":"articletitle","label":"Article Title"},{"value":"Emergency Medicine Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.emc.2015.07.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2015 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}