Abstract:
Mental disorders can evolve unpredictably, generating both psychological and somatic complications that
require emergency intervention and transfer to intensive care (ICU). Although hospitalization of psychiatric
patients in ICUs remains relatively rare, it indicates an extreme form of decompensation. Assessment of
clinical characteristics and causes that resulted in patients with mental disorders being transferred to the ICU
section after initially being hospitalized in psychiatric wards. A retrospective study was conducted throughout
the year 2025 at the IMSP Clinical Psychiatric Hospital. The study included all patients transferred from
psychiatric wards to the ICU during this period. Data were collected on psychiatric diagnoses, reasons for ICU
transfer, administered pharmacological treatments, and somatic comorbidities. The cohort included patients
aged 13 to 90 years, children (<18 years): 2- (2.0%), women: 57- (57.0%), men: 43- (43.0%); 47% being repeat
admissions. The most common psychiatric diagnoses were paranoid schizophrenia (61.7%), dementia (17%)
and organic delusional disorder (6.4%). Somatic comorbidities were identified in 72.3% of cases, including
ischemic cardiomyopathy, MODS, infections, and metabolic disorders. In 27.7% of patients, transfer was
prompted by severe psychiatric complications, such as life-threatening behavioral syndromes, catatonia, or
critical refusal of food intake. The ICU mortality rate was 9.6%. Admission to the ICU reflects the severity of
the decompensation of mental disorders and the complexity of associated somatic complications. Continuous
evaluation and interdisciplinary collaboration are critical for early risk identification and individualized
therapeutic management.
