Edwin D Boudreaux1, Consuelo Cagande, Hope Kilgannon, Anita Kumar, Carlos A Camargo. 1. Departments of Emergency Medicine and Psychiatry, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School and Cooper University Hospital, Camden, N.J, USA. boudreaux-edwin@cooperhealth.edu
Abstract
OBJECTIVE: To determine prevalence and predictors of depression among emergency department (ED) patients. METHOD: For 1 week in November 2003, consecutive adult patients presenting to an urban ED from 8:00 a.m. to midnight were screened for a DSM-IV major depressive episode using the Harvard Department of Psychiatry National Depression Screening Day Scale. Patients who were severely ill or who had altered mental status were excluded. Demographic factors, psychiatric history, and brief medical history also were assessed. RESULTS: Of 182 patients enrolled, 57 (32%, 95% CI = 25 to 39) screened positive for depression, which was much greater than general community estimates (6.6%, p < .0001). Depression was more likely (p < .001) in patients with a psychiatric history (61% vs. 22%), substance abuse history (65% vs. 30%), or a suicide attempt (67% vs. 30%). Eleven percent (95% CI = 7 to 17) of subjects endorsed suicidal ideation at least "some of the time." LIMITATIONS: This sample underrepresented severely ill, acutely distressed, or cognitively disabled patients. The most likely effect of these exclusion criteria was to yield an underestimate of depression. Also, the ED was located in a northeastern, urban city, which may not represent the rest of the country. Finally, we used a screening instrument without established operating characteristics within the ED setting. CONCLUSION: Although findings suggest that depression is common, it is often ignored in the ED setting. Recent efforts to increase awareness of depression in outpatient medical settings may be warranted in EDs as well.
OBJECTIVE: To determine prevalence and predictors of depression among emergency department (ED) patients. METHOD: For 1 week in November 2003, consecutive adult patients presenting to an urban ED from 8:00 a.m. to midnight were screened for a DSM-IV major depressive episode using the Harvard Department of Psychiatry National Depression Screening Day Scale. Patients who were severely ill or who had altered mental status were excluded. Demographic factors, psychiatric history, and brief medical history also were assessed. RESULTS: Of 182 patients enrolled, 57 (32%, 95% CI = 25 to 39) screened positive for depression, which was much greater than general community estimates (6.6%, p < .0001). Depression was more likely (p < .001) in patients with a psychiatric history (61% vs. 22%), substance abuse history (65% vs. 30%), or a suicide attempt (67% vs. 30%). Eleven percent (95% CI = 7 to 17) of subjects endorsed suicidal ideation at least "some of the time." LIMITATIONS: This sample underrepresented severely ill, acutely distressed, or cognitively disabled patients. The most likely effect of these exclusion criteria was to yield an underestimate of depression. Also, the ED was located in a northeastern, urban city, which may not represent the rest of the country. Finally, we used a screening instrument without established operating characteristics within the ED setting. CONCLUSION: Although findings suggest that depression is common, it is often ignored in the ED setting. Recent efforts to increase awareness of depression in outpatient medical settings may be warranted in EDs as well.
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Doreen Koretz; Kathleen R Merikangas; A John Rush; Ellen E Walters; Philip S Wang Journal: JAMA Date: 2003-06-18 Impact factor: 56.272
Authors: Marian E Betz; Sarah A Arias; Matthew Miller; Catherine Barber; Janice A Espinola; Ashley F Sullivan; Anne P Manton; Ivan Miller; Carlos A Camargo; Edwin D Boudreaux Journal: Psychiatr Serv Date: 2015-03-01 Impact factor: 3.084
Authors: David G Beiser; Charlotte E Ward; Milkie Vu; Neda Laiteerapong; Robert D Gibbons Journal: Acad Emerg Med Date: 2019-04-07 Impact factor: 3.451
Authors: Edwin D Boudreaux; Consuelo Cagande; J Hope Kilgannon; Sunday Clark; Carlos A Camargo Journal: Prim Care Companion J Clin Psychiatry Date: 2006
Authors: Marian E Betz; Matthew Miller; Catherine Barber; Brenda Beaty; Ivan Miller; Carlos A Camargo; Edwin D Boudreaux Journal: Depress Anxiety Date: 2016-03-17 Impact factor: 6.505
Authors: Matthew J Mimiaga; William M Reichmann; Steven A Safren; Elena Losina; Christian Arbelaez; Rochelle P Walensky Journal: Prim Care Companion J Clin Psychiatry Date: 2010
Authors: Marian E Betz; Ashley F Sullivan; Anne P Manton; Janice A Espinola; Ivan Miller; Carlos A Camargo; Edwin D Boudreaux Journal: Depress Anxiety Date: 2013-02-20 Impact factor: 6.505
Authors: Edwin D Boudreaux; Carlos A Camargo; Sarah A Arias; Ashley F Sullivan; Michael H Allen; Amy B Goldstein; Anne P Manton; Janice A Espinola; Ivan W Miller Journal: Am J Prev Med Date: 2015-12-04 Impact factor: 5.043
Authors: Jeffrey M Caterino; Ashley F Sullivan; Marian E Betz; Janice A Espinola; Ivan Miller; Carlos A Camargo; Edwin D Boudreaux Journal: Acad Emerg Med Date: 2013-08 Impact factor: 3.451