Naturalistic data on acute psychiatric inpatient treatment is scarce, data from RCT's are less relevant due to exclusion criteria for more severelly ill inpatients and lack of capacity to give informed consent. Treatment recommendations are influenced more by data on less acutely ill psychiatric inpatients.

All inpatients admitted to PICU during one month were screened for diagnosis (ICD-10), severity of illness and symptoms (CGI and GAS), therapy and speed of significant clinical improvement (observation) at admission, in 24 hours and at discharge.

227 consecutive PICU admissions were included, gender ratio=1, average GAS 41, CGI 5. Median lenght of hospitalization was 2.5 days. Atypical to typical antipsychotics ratio was 4:1, rate of clinical improvement was 35%. Results were compared with results of similar study 7 years ago and the difference in the profile of antipsychotic drugs usage was significant and favoured atypicals.

Antipsychotics and benzodiazepins are most often used drugs to control acute psychopathology. The use of classical AP's is diminishing in recent years without the lost of efficacy. The CPZ equivalent dosages are however higher then recommended in the literature and reflect more the everyday clinical practice.