Frequent users of emergency departments present very high prevalence of mental health and substance use disorders, which are largery underdiagnosed by clinicians
Détails
ID Serval
serval:BIB_715B73AD00A7
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Poster: résume de manière illustrée et sur une page unique les résultats d'un projet de recherche. Les résumés de poster doivent être entrés sous "Abstract" et non "Poster".
Collection
Publications
Institution
Titre
Frequent users of emergency departments present very high prevalence of mental health and substance use disorders, which are largery underdiagnosed by clinicians
Titre de la conférence
80. Jahresversammlung der Schweizerischen Gesellschaft für Allgemeine Innere Medizin
Adresse
Basel, Schweiz, 23.-25. Mai 2012
ISSN-L
1424-4977
Statut éditorial
Publié
Date de publication
2012
Volume
12
Série
Swiss Medical Forum
Pages
33S
Langue
anglais
Résumé
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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Création de la notice
07/02/2013 12:02
Dernière modification de la notice
22/07/2021 5:36
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