Psychosocial stressors and precipitants

It is important to first consider acute changes or biological causes for a patient's deterioration but often there is no apparent change in a patient's baseline mental state
Although patients present to the ED for a variety of reasons, they usually pertain to some common themes
The patient often describe chronic, recurrent issues that date may back for months to years but it is more important to determine if there has been a recent change in the situation that has resulted in their de-compensation
Not uncommonly patients will not immediately reveal the reason for their presentation until pressed further (this may be due to embarrassment, lack of insight or a deliberate attempt to manipulate psychiatric services)
It is important to address the stressors as part of the overall management of the patient

Common reasons for presentation