Citation

O'Reilly LM, Dalal AI, Maag S, Perry MT, Card A, Bohrer MB, Hamersly J, Mohammad Nader S, Peterson K, Beiser DG, Gibbons RD, D'Onofrio BM, Musey PI. J. Am. Coll. Emerg. Physicians Open 2022; 3(5).

Copyright

(Copyright © 2022, John Wiley and Sons)

DOI

10.1002/emp2.12804

PMID

unavailable

Abstract

OBJECTIVES: To assess: (1) the prevalence of mental health and substance use in patients presenting to the emergency department (ED) through use of a computer adaptive test (CAT-MH), (2) the correlation among CAT-MH scores and self- and clinician-reported assessments, and (3) the association between CAT-MH scores and ED utilization in the year prior and 30 days after enrollment.

METHODS: This was a single-center observational study of adult patients presenting to the ED for somatic complaints (97%) from May 2019 to March 2020. The main outcomes were computer-adaptive-assessed domains of suicidality, depression, anxiety, post-traumatic stress disorder (PTSD), and substance use. We conducted Pearson correlations and logistic regression for objectives 2 and 3, respectively.

RESULTS: From a sample of 794 patients, the proportion of those at moderate/severe risk was: 24.1% (suicidality), 8.3% (depression), 16.5% (anxiety), 12.3% (PTSD), and 20.4% (substance use). CAT-MH domains were highly correlated with self-report assessments (r = 0.49-0.79). Individuals who had 2 or more ED visits in the prior year had 62% increased odds of being in the intermediate-high suicide risk category (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.07-2.44) compared to those with zero prior ED visits. Individuals who scored in the intermediate-high-suicide risk group had 63% greater odds of an ED visit within 30 days after enrollment compared to those who scored as low risk (OR, 1.63; 95% CI, 1.09, 2.44).

CONCLUSION: The CAT-MH documented that a considerable proportion of ED patients presenting for somatic problems had mental health conditions, even if mild. Mental health problems were also associated with ED utilization. © 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.

Language: en

Keywords

adult; human; mental health; suicide; female; male; depression; prevalence; screening; anxiety; substance use; suicidal behavior; disease severity; longitudinal study; posttraumatic stress disorder; pain; risk factor; major clinical study; controlled study; behavior disorder; self report; emergency ward; psychosomatic disorder; high risk patient; sensitivity analysis; health care utilization; logistic regression analysis; correlation analysis; confidence interval; correlation coefficient; Article; observational study; outcome assessment; clinical assessment; utilization; emergency patient; demographics; odds ratio; computerized adaptive testing; intermediate risk patient