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Occult Suicidality and Psychiatric Disease Among Emergency Department Patients with Low-acuity Chief Complaints

机译:急诊科主诉低敏的隐匿性自杀和精神疾病

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Introduction: Patients presenting to emergency departments (ED) are often screened for suicidality, even when their chief complaint does not involve mental health concerns. Patient receptiveness to ED-based mental health screening and intervention is unknown, particularly among patients with low-acuity chief complaints, who often prioritize rapid evaluation and discharge. Methods: This cross-sectional study included adults with low-acuity chief complaints presenting to an urban, academic ED in the Northeastern United States during daytime and evening hours, from 2015 to 2016. Participants completed validated mental health screening instruments, including the Suicide Behaviors Questionnaire-Revised and the Patient Health Questionnaire-4. Participants were also asked to rate the importance of addressing mental health concerns during their ED visit. Results: We approached 1,688 patients, and 816 (48.4%) consented to participate in the study. Of these, 27% screened positive for anxiety and 25% screened positive for depression. Even among patients with no prior depression history, 17% were at high risk of depression. Eleven percent of participants were at high risk for suicidal behavior, including 5% of those with no reported history of depression or bipolar disorder. Thirty-five percent of patients at risk for suicide and 53% of those at high risk of depression thought it was important or very important to address these issues during the ED visit. Conclusion: Symptoms of mental health disorders were common among this group of ED patients presenting with low-acuity chief complaints. Patients often desired to address these mental health concerns as part of their ED visit.
机译:简介:就诊至急诊室(ED)的患者通常会进行自杀检查,即使他们的主要抱怨并不涉及精神健康问题。尚不清楚患者是否接受基于ED的心理健康筛查和干预,特别是在那些低敏度主诉患者中,他们通常优先考虑快速评估和出院。方法:这项横断面研究包括2015年至2016年白天和晚上在美国东北部城市,学术急诊科就诊的低敏度主诉成年人。参与者完成了经验证的心理健康筛查工具,包括自杀行为经修订的问卷和患者健康问卷-4。还要求与会人员评价他们在急诊室就诊时解决心理健康问题的重要性。结果:我们接近了1688名患者,其中816名(48.4%)同意参加该研究。其中,有27%的人筛查焦虑呈阳性,有25%的人筛查抑郁呈阳性。即使在没有抑郁史的患者中,也有17%处于抑郁的高风险中。 11%的参与者有自杀行为的高风险,其中5%的人没有抑郁或双相情感障碍的病史。 35%的自杀风险患者和53%的高抑郁风险患者认为在ED访视期间解决这些问题很重要或非常重要。结论:在这些表现为低敏度主诉的ED患者中,精神健康障碍的症状很常见。患者通常希望在急诊就诊时解决这些心理健康问题。

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