TY - JOUR PY - 2022// TI - Computer adaptive testing to assess impairing behavioral health problems in emergency department patients with somatic complaints JO - Journal of the American College of Emergency Physicians open A1 - O'Reilly, L.M. A1 - Dalal, A.I. A1 - Maag, S. A1 - Perry, M.T. A1 - Card, A. A1 - Bohrer, M.B. A1 - Hamersly, J. A1 - Mohammad Nader, S. A1 - Peterson, K. A1 - Beiser, D.G. A1 - Gibbons, R.D. A1 - D'Onofrio, B.M. A1 - Musey, P.I. SP - EP - VL - 3 IS - 5 N2 - 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

LA - en SN - 2688-1152 UR - http://dx.doi.org/10.1002/emp2.12804 ID - ref1 ER -