PMID: 18208649Jan 23, 2008Paper

Prevalence of psychiatric diagnoses among frequent users of rural emergency medical services

Canadian Journal of Rural Medicine : the Official Journal of the Society of Rural Physicians of Canada = Journal Canadien De La Médecine Rurale : Le Journal Officiel De La Société De Médecine Rurale Du Canada
Lewis E Mehl-Madrona

Abstract

This study aimed to determine whether there was an increased prevalence of psychiatric disorders among frequent users of rural emergency medical services. In a matched comparison design, I compared frequent users of the emergency departments of 2 rural hospitals, both affiliated with an academic centre, with randomly selected users and with randomly selected users who had the same medical diagnoses. The main outcome measures were psychiatric diagnoses on a structured clinical interview, along with medical diagnoses and number of emergency department visits in the past year. Ninety-three percent of frequent users had at least 1 DSM-IV psychiatric diagnosis, differing from 50% of random users matched for presenting complaint. A random user group, not matched for presenting complaint, showed 28% prevalence of DSM-IV diagnoses. Frequent users were more often state insured (Medicaid) and less often insured privately. The most common diagnoses among frequent users were major depression, generalized anxiety disorder, adjustment disorder, somatoform pain disorder, substance abuse and dependence, and dysthymia. The treating emergency department physician mentioned a psychiatric diagnosis for only 9% of frequent users. Frequent users hav...Continue Reading

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