Frequent users of emergency departments present very high prevalence of mental health and substance use disorders, which are largely underdiagnosed by clinicians
Details
Serval ID
serval:BIB_1AA2A3CB2D5C
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Frequent users of emergency departments present very high prevalence of mental health and substance use disorders, which are largely underdiagnosed by clinicians
Title of the conference
80. Jahresversammlung der Schweizerischen Gesellschaft für Allgemeine Innere Medizin
Address
Basel, Schweiz, 23.-25. Mai 2012
ISBN
1424-4985
ISSN-L
1424-4977
Publication state
Published
Issued date
2012
Volume
12
Series
Swiss Medical Forum = Forum Médical Suisse
Pages
33S
Language
english
Abstract
Background: The objective of this study was to determine if mental
health and substance use diagnoses were equally detected in frequent
users (FUs) compared to infrequent users (IUs) of emergency
departments (EDs).
Methods: In a sample of 399 adult patients (>= 18 years old) admitted
to a teaching hospital ED, we compared the mental health and
substance use disorders diagnoses established clinically and consigned
in the medical files by the ED physicians to data obtained in face-to-face
research interviews using the Primary Care Evaluation of Mental
Disorders (PRIME-MD) and the Alcohol, Smoking and Involvement
Screening Test (ASSIST). Between November 2009 and June 2010,
226 FUs (>4 visits within a year) who attended the ED were included,
and 173 IUs (<= 4 visits within a year) were randomly selected from a
pool of identified patients to comprise the comparison group.
Results: For mental health disorders identified by the PRIME-MD, FUs
were more likely than IUs to have an anxiety (34 vs. 16%, Chi2(1) =
16.74, p <0.001), depressive (47 vs. 25%, Chi2(1) = 19.11, p <0.001) or
posttraumatic stress (PTSD) disorder (11 vs. 5%, Chi2(1) = 4.87, p =
0.027). Only 3/76 FUs (4%) with an anxiety disorder, 16/104 FUs (15%)
with a depressive disorder and none of the 24 FUs with PTSD were
detected by the ED medical staff. None of the 27 IUs with an anxiety
disorder, 6/43 IUs (14%) with a depressive disorder and none of the
8 IUs with PTSD were detected. For substance use disorders identified
by the ASSIST, FUs were more at risk than IUs for alcohol (24 vs. 7%,
Chi2(1) = 21.12, p <0.001) and drug abuse/dependence (36 vs. 25%,
Chi2(1) = 5.52, p = 0.019). Of the FUs, 14/54 (26%) using alcohol and
8/81 (10%) using drugs were detected by the ED physicians. Of the IUs,
5/12 (41%) using alcohol and none of the 43 using drugs were detected.
Overall, there was no significant difference in the rate of detection of
mental health and substance use disorders between FUs and IUs
(Fisher's Exact Test: anxiety, p = 0.567; depression, p = 1.000; PTSD,
p = 1.000; alcohol, p = 0.517; and drugs, p = 0.053).
Conclusions: While the prevalence of mental health and substance
use disorders was higher among FUs, the rates of detection were not
significantly different for FUs vs. IUs. However, it may be that drug
disorders among FUs were more likely to be detected.
health and substance use diagnoses were equally detected in frequent
users (FUs) compared to infrequent users (IUs) of emergency
departments (EDs).
Methods: In a sample of 399 adult patients (>= 18 years old) admitted
to a teaching hospital ED, we compared the mental health and
substance use disorders diagnoses established clinically and consigned
in the medical files by the ED physicians to data obtained in face-to-face
research interviews using the Primary Care Evaluation of Mental
Disorders (PRIME-MD) and the Alcohol, Smoking and Involvement
Screening Test (ASSIST). Between November 2009 and June 2010,
226 FUs (>4 visits within a year) who attended the ED were included,
and 173 IUs (<= 4 visits within a year) were randomly selected from a
pool of identified patients to comprise the comparison group.
Results: For mental health disorders identified by the PRIME-MD, FUs
were more likely than IUs to have an anxiety (34 vs. 16%, Chi2(1) =
16.74, p <0.001), depressive (47 vs. 25%, Chi2(1) = 19.11, p <0.001) or
posttraumatic stress (PTSD) disorder (11 vs. 5%, Chi2(1) = 4.87, p =
0.027). Only 3/76 FUs (4%) with an anxiety disorder, 16/104 FUs (15%)
with a depressive disorder and none of the 24 FUs with PTSD were
detected by the ED medical staff. None of the 27 IUs with an anxiety
disorder, 6/43 IUs (14%) with a depressive disorder and none of the
8 IUs with PTSD were detected. For substance use disorders identified
by the ASSIST, FUs were more at risk than IUs for alcohol (24 vs. 7%,
Chi2(1) = 21.12, p <0.001) and drug abuse/dependence (36 vs. 25%,
Chi2(1) = 5.52, p = 0.019). Of the FUs, 14/54 (26%) using alcohol and
8/81 (10%) using drugs were detected by the ED physicians. Of the IUs,
5/12 (41%) using alcohol and none of the 43 using drugs were detected.
Overall, there was no significant difference in the rate of detection of
mental health and substance use disorders between FUs and IUs
(Fisher's Exact Test: anxiety, p = 0.567; depression, p = 1.000; PTSD,
p = 1.000; alcohol, p = 0.517; and drugs, p = 0.053).
Conclusions: While the prevalence of mental health and substance
use disorders was higher among FUs, the rates of detection were not
significantly different for FUs vs. IUs. However, it may be that drug
disorders among FUs were more likely to be detected.
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