geðshræring

Geðshræring, often translated as psychiatric agitation, is a term used in Icelandic psychiatry to describe acute mental agitation and restlessness that can occur in a range of psychiatric and medical conditions. It is characterized by increased psychomotor activity, heightened arousal, and a variable combination of irritability, pressured speech, rapid thoughts, and disinhibition. Individuals may pace, fidget, shout, or become difficult to calm. Geðshræring can be a manifestation of mood disorders (such as mania), acute psychosis, delirium, intoxication or withdrawal from substances, severe anxiety, pain, hypoxia, infection, or metabolic disturbances.

Assessment aims to ensure safety and identify underlying causes. Clinicians perform a medical workup to rule out organic pathology (vital signs, oxygenation, glucose, electrolytes, toxins) and conduct a focused mental status examination. Information from the patient and collateral sources helps determine mood, thought content, cognitive status, and possible delirium or psychosis.

Management prioritizes safety and de-escalation. Nonpharmacological strategies include creating a calm environment, involving trusted staff, and employing verbal de-escalation techniques. Pharmacologic treatment may be used to reduce agitation when necessary, with short-acting antipsychotics and/or benzodiazepines as options, chosen based on the suspected underlying diagnosis and patient factors. In delirium or intoxication, addressing the underlying cause is essential. Severe agitation may require temporary observation or hospitalization for comprehensive care.

Prognosis depends on the underlying condition driving the agitation. Geðshræring often resolves with appropriate treatment of the root cause, though it can persist or recur in chronic psychiatric disorders or recurrent delirium.