Acute behavioral disturbance (ABD) is an

umbrella term In linguistics, semantics, general semantics, and ontologies, hyponymy () is a semantic relation between a hyponym denoting a subtype and a hypernym or hyperonym (sometimes called umbrella term or blanket term) denoting a supertype. In other wor ...

referring to various conditions of

medical emergency A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified p ...

where a person behaves in a manner that may put themselves or others at risk. It is not a formal

diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...

. Another controversial term, ''

excited delirium Excited delirium (ExDS), also known as agitated delirium (AgDS), is a controversial diagnosis sometimes characterized as a potentially fatal state of extreme agitation and delirium. It is typically diagnosed postmortem in young adult males, dispr ...

'', is sometimes used interchangeably with ABD (although according to definitions adopted by the Faculty of Forensic and Legal Medicine of the

Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...

in England, "only about one-third of cases of ABD present as excited delirium"). According to the Faculty of Forensic and Legal Medicine, ABD can be caused by a number of conditions including

psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...

(potentially due to

bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...

substance abuse Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, ...

hypoglycemia Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose belo ...

akathisia Akathisia is a movement disorder characterized by a subjective feeling of inner restlessness accompanied by mental distress and an inability to sit still. Usually, the legs are most prominently affected. Those affected may fidget, rock back and ...

hypoxia Hypoxia means a lower than normal level of oxygen, and may refer to: Reduced or insufficient oxygen * Hypoxia (environmental), abnormally low oxygen content of the specific environment * Hypoxia (medical), abnormally low level of oxygen in the tis ...

head injury A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of inju ...

as well as other conditions. Treatment generally consists of verbal deescalation, voluntary

sedation Sedation is the reduction of irritability or agitation by administration of sedative drugs, generally to facilitate a medical procedure or diagnostic procedure. Examples of drugs which can be used for sedation include isoflurane, diethyl ether, ...

with

antipsychotics Antipsychotics, also known as neuroleptics, are a class of Psychiatric medication, psychotropic medication primarily used to manage psychosis (including delusions, hallucinations, paranoia or disordered thought), principally in schizophrenia but ...

benzodiazepine Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...

, or

involuntary treatment Involuntary treatment (also referred to by proponents as assisted treatment and by critics as forced drugging) refers to medical treatment undertaken without the consent of the person being treated. Involuntary treatment is permitted by law in so ...

with antipsychotics, benzodiazepines or

ketamine Ketamine is a dissociative anesthetic used medically for induction and maintenance of anesthesia. It is also used as a recreational drug. It is one of the safest anesthetics, as, in contrast with opiates, ether, and propofol, it suppresses ne ...

through

intramuscular injection Intramuscular injection, often abbreviated IM, is the injection of a substance into a muscle. In medicine, it is one of several methods for parenteral administration of medications. Intramuscular injection may be preferred because muscles have ...

as a means of

chemical restraint A chemical restraint is a form of medical restraint in which a drug is used to restrict the freedom or movement of a patient or in some cases to sedate the patient. Chemical restraint is used in emergency, acute, and psychiatric settings to perfor ...

through rapid tranquilization possibly combined with

physical restraint Physical restraint refers to means of purposely limiting or obstructing the freedom of a person's bodily movement. Basic methods Usually, binding objects such as handcuffs, legcuffs, ropes, chains, straps or straitjackets are used for this ...

Treatment in a medical setting

The initial treatment is through verbal descalation through encouraging patient to go to an area to avoid arousal, avoidance of confrontational body language or tone of voice. If this is not effective chemical restraint is used, as well as physical restraint. Internationally there is some difference in the guidelines for chemical restraint, some guidelines suggest that sedatives should be used alone initially, while others suggest that antipsychotics alone should be used initially. The UK's

National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...

has produced guidelines for handling violence and the risk of violence in psychiatric and emergency departments. When using

National Institute for Health and Care Excellence The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health and Social Care in England that publishes guidelines in four areas: * the use of health technologies withi ...

suggest supine rather than prone restraint and that physical restraint should ideally not last longer than 10 minutes. In Australia, so-called behavioural assessment rooms are provided in emergency rooms where an aggressive patient can be moved to. These rooms are alarmed, allow for a patient to be observed from outside, are hidden from the rest of the emergency ward, and are acoustically conditioned to prevent others in the ward from hearing what is going on in the room. They are fitted with restraints that are kept out of sight. They are designed to prevent the individual from self-inflicted suffocation.

Treatment in police custody

In the UK, police guidelines allow for rapid tranquilization in a police station, but only if administered by a

paramedic A paramedic is a registered healthcare professional who works autonomously across a range of health and care settings and may specialise in clinical practice, as well as in education, leadership, and research. Not all ambulance personnel are p ...

References

{{Mental disorders Abnormal psychology